No office rate
33140 is for standalone TMR through thoracotomy. 33141 is used when TMR is performed during another cardiac procedure.
On this page
CMS RVU26D · Effective 2026-10-01
33140 Heart revascularization Medicare reimbursement rates in Kentucky
Reports laser-created channels in the heart muscle through thoracotomy when transmyocardial revascularization is performed as a standalone operation. Compare 33140 office and facility rates across CMS payment localities in Kentucky.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 33140 in Kentucky?
Kentucky has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1417.95
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Cardiac surgery
About 33140: Standalone transmyocardial laser revascularization
Reports laser-created channels in the heart muscle through thoracotomy when transmyocardial revascularization is performed as a standalone operation.
A cardiothoracic surgeon performs transmyocardial laser revascularization through a thoracotomy, creating channels in the heart muscle to address severe angina in selected patients whose coronary disease is not suitable for conventional revascularization. The procedure is performed in an operating room. This code is for TMR performed as a standalone operation; when TMR accompanies another cardiac operation, the separate code for that circumstance is 33141.
Report 33140 when the operative record supports standalone TMR and documents the thoracotomy and laser treatment. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral adjustment is not appropriate. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 33140
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU27.63 · 63%
- Practice expense (office) RVU9.87 · 22%
- Malpractice RVU6.61 · 15%
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
33140 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
33533 describes coronary bypass using one arterial graft. It is a bypass operation, not laser channel creation in the heart muscle.
No office rate
92920 describes percutaneous coronary angioplasty of one major artery or branch. It uses a catheter-based approach rather than thoracotomy and TMR.
Compare 33140 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Kentucky →
Office / nonfacility
Unavailable
Facility
$1417.95
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33140 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
3,826
- Code
- 33140
- Physician work
- 27.63
- Practice expense
- 9.87
- Malpractice
- 6.61
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 27.63 | × 1.000 | 27.6300 |
| Practice expense | 9.87 | × 0.889 | 8.7744 |
| Malpractice | 6.61 | × 0.915 | 6.0482 |
| Total RVUs | 42.4526 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$1417.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 27.63 | 1 |
| Practice expense | 9.87 | 0.889 |
| Malpractice | 6.61 | 0.915 |
(27.63 × 1 + 9.87 × 0.889 + 6.61 × 0.915) × $33.4009 = $1417.95
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
33140 billing questions
When should 33140 be chosen instead of 33141?
Use 33140 for TMR performed as a standalone operation. Use 33141 when TMR is performed during another cardiac procedure.
Can TMR be reported with a coronary bypass procedure?
When TMR is performed during a bypass or another cardiac operation, 33141 describes that TMR circumstance; 33140 is for standalone TMR.
Does modifier 50 apply to 33140?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,82333050,,Resect heart sac lesion,A,,16.55,8.30,NA,8.30,,4.17,29.02,29.02,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82433120,,Exc icar tum resc w/card byp,A,,37.49,11.70,NA,11.70,,9.24,58.43,58.43,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82533130,,Rescj external cardiac tumor,A,,23.57,10.02,NA,10.02,,5.63,39.22,39.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82633140,,Heart revascularize (tmr),A,,27.63,9.87,NA,9.87,,6.61,44.11,44.11,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82733141,,Heart tmr w/other procedure,A,,2.48,0.48,NA,0.48,,0.62,3.58,3.58,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8283315F,,Er+ or pr+ breast cancer,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8293316F,,Er- or pr- breast cancer,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631