Billing code 33768: Cavopulmonary anastomosisMedicare rate & RVUs in Maine
Reports the additional cavopulmonary connection of a second superior vena cava during surgical palliation for congenital heart disease with bilateral superior vena cavae.
CMS doesn’t publish an office rate for 33768 in Maine.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 33768 covers
This add-on identifies the additional surgical connection of a second superior vena cava to the pulmonary artery circulation, typically when a patient has bilateral superior vena cavae and undergoes cavopulmonary palliation. Congenital cardiac surgeons perform the work in the operating room, often in children with complex congenital heart disease. The operative report should establish the bilateral venous anatomy and describe the separate connection made for the second vena cava.
Report 33768 with the primary cavopulmonary procedure, not as a stand-alone service. Select the primary code based on the extent and configuration of the main SVC-to-pulmonary-artery operation; this code identifies the additional second-SVC anastomosis. Documentation should distinguish that work from the primary connection. CMS treats this as an add-on code billed only with a primary procedure, and payment is included within that procedure's global period.
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.
Where 33768 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | Unavailable | $348.57 |
| Southern Maine | Unavailable | $352.81 |
How the 33768 rate is calculated
Each of 33768’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 33768
RVUs × geographic indexes × conversion factor
Work7.80
7.80 RVUs× 1.000 GPCI
Practice expense1.54
1.54 RVUs× 1.000 GPCI
Malpractice1.96
1.96 RVUs× 1.000 GPCI
Adjusted RVUs
11.3000
Conversion factor
$33.4009
Medicare rate
$377.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33768
The CMS indicators that decide how 33768 is paid alongside other services.
CMS payment indicators · 33768
Cavopulmonary anastomosis
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
33768 without 80 · national facility
$377.43
Cavopulmonary anastomosis
33768-80 · Assistant: 16%
$60.39
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
33768 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33766Glenn shunt
- 33766 describes the primary SVC-to-pulmonary-artery shunt involving one lung. Use 33768 to identify the additional connection for a second superior vena cava.
- 33767Cavopulmonary shunt
- 33767 describes an SVC-to-pulmonary-artery shunt involving both lungs. 33768 identifies an additional second-SVC connection, not the lung extent of the primary shunt.
- 33750Systemic-to-pulmonary shunt
- 33750 creates a shunt from the subclavian artery to the pulmonary artery. 33768 concerns a second superior vena cava in a cavopulmonary operation.
33768 billing questions
Can 33768 be reported by itself?
No. It is an add-on code and must be reported with the primary procedure for the cavopulmonary operation.
What documentation supports 33768?
Document bilateral superior vena cava anatomy and the separate cavopulmonary connection created for the second vena cava.
How is 33768 different from 33766?
33766 describes the primary SVC-to-pulmonary-artery shunt involving one lung. 33768 identifies the additional connection for a second superior vena cava.
How is 33768 different from 33767?
33767 describes an SVC-to-pulmonary-artery shunt involving both lungs. 33768 identifies work for a second superior vena cava, rather than the pulmonary distribution of the primary shunt.
How is payment handled for this add-on?
CMS payment for 33768 is within the primary procedure's global period. The code is reported only with a qualifying primary procedure.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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