Billing code 33267: LAA exclusionMedicare rate & RVUs in Minnesota
Reports open surgical exclusion of the left atrial appendage as a standalone service, using a method such as suturing, stapling, or excision.
CMS doesn’t publish an office rate for 33267 in Minnesota.
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 33267 covers
The surgeon excludes the left atrial appendage through an open approach, using the method appropriate to the operation, such as suturing, stapling, or excision. This service is used in selected patients with atrial fibrillation as part of surgical stroke-risk management. Cardiothoracic surgeons typically perform it in an operating room, either as a standalone procedure or alongside other cardiac surgery; when it accompanies another cardiac procedure, the related add-on code distinguishes that circumstance.
Select this code for open LAA exclusion performed as a standalone service, not for a thoracoscopic approach or exclusion performed during another cardiac procedure. The operative report should identify the open approach, the appendage treated, the exclusion method, and whether another cardiac procedure was performed in the same session. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
33267 in Minnesota
| Payment locality | Office | Facility |
|---|---|---|
| Minnesota | Unavailable | $891.40 |
How the 33267 rate is calculated
Each of 33267’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 · 33267
RVUs × geographic indexes × conversion factor
Work18.04
18.04 RVUs× 1.000 GPCI
Practice expense7.13
7.13 RVUs× 1.000 GPCI
Malpractice4.43
4.43 RVUs× 1.000 GPCI
Adjusted RVUs
29.6000
Conversion factor
$33.4009
Medicare rate
$988.67
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33267
33267 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33267
LAA exclusion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33267
LAA exclusion
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33267 without 51 · national facility
$988.67
LAA exclusion
33267-51 · Second procedure: 50%
$494.34
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
33267 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33268LAA exclusion
- Both describe open LAA exclusion, but 33267 is for a standalone service; 33268 is used when exclusion is performed during another cardiac procedure.
- 33269LAA exclusion
- Choose 33267 for open surgical access and 33269 for a thoracoscopic approach.
- 33254Atrial ablation
- 33254 reports limited atrial ablation, not LAA exclusion. Report 33267 only when the appendage itself is surgically excluded by an open approach.
33267 billing questions
When should 33267 be used instead of 33268?
Use 33267 for open LAA exclusion performed as a standalone service. Use 33268 when open LAA exclusion is performed during another cardiac procedure.
How does 33267 differ from 33269?
33267 describes an open approach. 33269 is for thoracoscopic LAA exclusion.
Can the LAA exclusion be reported with another cardiac procedure?
If open LAA exclusion is performed during another cardiac procedure, report the applicable add-on code, 33268, rather than 33267. Document the procedures and the operative approach.
What documentation supports reporting 33267?
The operative report should establish the open approach, the left atrial appendage treated, the exclusion method, and whether the service was standalone or performed during another cardiac procedure.
Can modifier 50 be reported, and can an assistant be paid?
Modifier 50 is inappropriate based on the descriptor and anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
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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