No office rate
33745 reports the initial stent-created intracardiac shunt and is required with 33746. Use 33746 for each additional shunt created in the same procedure.
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CMS RVU26D · Effective 2026-10-01
33746 Intracardiac shunt Medicare reimbursement rates in Nebraska
Report 33746 for each additional intracardiac shunt created by stent placement during a congenital heart catheterization, alongside the initial-shunt code. Compare 33746 office and facility rates across CMS payment localities in Nebraska.
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 33746 in Nebraska?
Nebraska 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
$328.71
1 of 1 localities have a supported rate.
Payment area: Nebraska
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.
Congenital cardiology
About 33746: Additional transcatheter intracardiac shunt
Report 33746 for each additional intracardiac shunt created by stent placement during a congenital heart catheterization, alongside the initial-shunt code.
Code 33746 represents creation of an additional transcatheter intracardiac shunt by stent placement for a congenital cardiac anomaly. It is used during an interventional cardiac catheterization, typically by a congenital or interventional cardiologist in a catheterization laboratory. The related initial-shunt service includes right and left heart catheterization, angiography, and imaging guidance as part of the procedure.
Report 33746 only with 33745, which covers the initial shunt. Use it for each additional shunt created, not simply for additional equipment used to create the same shunt. The operative or catheterization report should identify the congenital condition, the initial shunt, and each distinct additional shunt created. CMS classifies 33746 as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period.
CMS billing rules for 33746
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU7.80 · 70%
- Practice expense (office) RVU1.45 · 13%
- Malpractice RVU1.86 · 17%
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.
33746 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
33741 describes transcatheter atrial septostomy; 33746 applies to an additional intracardiac shunt created by stent placement with 33745.
No office rate
33750 describes a surgical shunt from the subclavian artery to the pulmonary artery, not an additional transcatheter intracardiac shunt.
Compare 33746 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$328.71
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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 33746 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
4,050
- Code
- 33746
- Physician work
- 7.80
- Practice expense
- 1.45
- Malpractice
- 1.86
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.80 | × 1.000 | 7.8000 |
| Practice expense | 1.45 | × 0.923 | 1.3383 |
| Malpractice | 1.86 | × 0.378 | 0.7031 |
| Total RVUs | 9.8414 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$328.71
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.8 | 1 |
| Practice expense | 1.45 | 0.923 |
| Malpractice | 1.86 | 0.378 |
(7.8 × 1 + 1.45 × 0.923 + 1.86 × 0.378) × $33.4009 = $328.71
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.
33746 billing questions
Can 33746 be reported without 33745?
No. Code 33746 is an add-on for an additional shunt and must be reported with 33745 for the initial shunt.
Is 33746 reported for each stent?
Report it for each additional shunt created, not for each stent used to create a single shunt.
What documentation supports an additional unit?
The catheterization report should distinguish each additional shunt from the initial shunt and describe its creation.
Are catheterization and imaging guidance separate services?
The initial-shunt service includes right and left heart catheterization, angiography, and imaging guidance. Document the procedural work performed rather than treating those included elements as additional shunts.
How does 33746 differ from 33741?
Code 33746 reports an additional stent-created intracardiac shunt with 33745. Code 33741 describes transcatheter atrial septostomy, a different 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 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.
4,04733736,,Revision of heart chamber,A,,23.71,10.53,NA,10.53,,5.98,40.22,40.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,04833741,,Tas congenital car anomal,A,,13.65,2.54,NA,2.54,,3.26,19.45,19.45,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,04933745,,Tis cgen car anomal 1st shnt,A,,19.50,3.64,NA,3.64,,4.68,27.82,27.82,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05033746,,Tis cgen car anomal ea addl,A,,7.80,1.45,NA,1.45,,1.86,11.11,11.11,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0513374F,,Ajcc brst cncr stage 1 docd,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
4,05233750,,Shunt subclavian to pulm art,A,,21.66,8.62,NA,8.62,,5.45,35.73,35.73,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05333755,,Shunt as-aort to pulm art,A,,22.04,10.20,NA,10.20,,5.55,37.79,37.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068