No office rate
Use 33503 when the anomalous coronary artery is repaired with bypass grafting. Code 33502 represents the ligation-based repair approach.
On this page
CMS RVU26D · Effective 2026-10-01
33503 Coronary repair Medicare reimbursement rates in Maryland
Reports surgical bypass grafting to restore blood flow when a coronary artery arises anomalously from the pulmonary artery, as in ALCAPA. Compare 33503 office and facility rates across CMS payment localities in Maryland.
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 33503 in Maryland?
Maryland has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1274.09–$1402.08
3 of 3 localities have a supported rate.
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.
Where 33503 pays more and less in Maryland
Cardiothoracic surgery
About 33503: Anomalous coronary artery bypass repair
Reports surgical bypass grafting to restore blood flow when a coronary artery arises anomalously from the pulmonary artery, as in ALCAPA.
This operation creates a bypass graft to supply blood to a coronary artery that originates from the pulmonary artery. It is used for congenital coronary anomalies, including anomalous left coronary artery from the pulmonary artery (ALCAPA), which can impair oxygen delivery to the heart muscle. A cardiothoracic or congenital heart surgeon performs the repair in an operating room; the operative report should establish the anomalous origin and describe the graft-based repair.
Report this code for the bypass repair, rather than a code for a different correction technique or routine bypass for acquired coronary disease. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. If other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33503
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU21.95 · 57%
- Practice expense (office) RVU10.77 · 28%
- Malpractice RVU5.53 · 14%
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.
33503 compared with similar codes
Office rates for Maryland, from the same CMS release.
No office rate
Both concern an anomalous coronary artery arising from the pulmonary artery, but 33504 represents a different repair technique. Follow the operative description rather than treating the codes as interchangeable.
No office rate
33510 is for single venous-graft CABG in a different clinical context. 33503 is specific to bypass repair of a coronary artery with anomalous pulmonary origin.
No office rate
33533 describes single arterial-graft CABG for a different clinical context; 33503 addresses the congenital anomalous-origin repair.
Compare 33503 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.
3 of 3 payment localities
Baltimore/Surr. Cntys →
Office / nonfacility
Unavailable
Facility
$1359.35
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1402.08
Rest Of Maryland →
Office / nonfacility
Unavailable
Facility
$1274.09
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33503 billing questions
When is 33503 different from 33502?
33503 describes bypass grafting to address a coronary artery arising from the pulmonary artery. Select 33502 when the documented repair is the ligation-based technique instead.
How does 33503 differ from 33504?
These codes distinguish surgical approaches to an anomalous coronary artery from the pulmonary artery. Use 33503 for a bypass graft repair; use 33504 when the operative report supports its distinct repair technique.
Can modifier 50 be used?
No. Bilateral adjustment is not appropriate for this anatomy, so modifier 50 should not be appended.
What documentation supports reporting 33503?
The operative report should identify the coronary artery's anomalous pulmonary origin and describe the bypass graft used to restore coronary blood flow.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures performed in that session are subject to a 50% payment reduction.
What documentation is needed for an assistant or co-surgeon?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
3,97233500,,Repair heart vessel fistula,A,,27.24,10.78,NA,10.78,,6.53,44.55,44.55,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,97333501,,Repair heart vessel fistula,A,,19.02,8.62,NA,8.62,,4.55,32.19,32.19,0,090,0.09,0.84,0.07,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,97433502,,Coronary artery correction,A,,21.30,10.02,NA,10.02,,5.36,36.68,36.68,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,97533503,,Coronary artery graft,A,,21.95,10.77,NA,10.77,,5.53,38.25,38.25,0,090,0.09,0.84,0.07,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,97633504,,Coronary artery graft,A,,24.82,10.75,NA,10.75,,6.25,41.82,41.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,97733505,,Repair artery w/tunnel,A,,37.44,9.96,NA,9.96,,9.43,56.83,56.83,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,97833506,,Repair artery translocation,A,,36.90,10.72,NA,10.72,,9.29,56.91,56.91,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00