Billing code 33140: Heart revascularizationMedicare rate & RVUs in Nevada
Reports laser-created channels in the heart muscle through thoracotomy when transmyocardial revascularization is performed as a standalone operation.
CMS doesn’t publish an office rate for 33140 in Nevada.
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 33140 covers
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.
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 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $1,436.77 |
How the 33140 rate is calculated
Each of 33140’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 · 33140
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 27.63Practice expense 9.87Malpractice 6.61
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33140
33140 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33140
Heart revascularization
| 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) | 0 | Not permitted. |
| 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 · 33140
Heart revascularization
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
33140 without 51 · national facility
$1,473.31
Heart revascularization
33140-51 · Second procedure: 50%
$736.66
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%).
33140 compared with similar codes
Compare codes
33140 vs 33141 vs 33533 vs 92920: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33141Heart revascularization
- 33140 is for standalone TMR through thoracotomy. 33141 is used when TMR is performed during another cardiac procedure.
- 33533Arterial CABG
- 33533 describes coronary bypass using one arterial graft. It is a bypass operation, not laser channel creation in the heart muscle.
- 92920Coronary angioplasty
- 92920 describes percutaneous coronary angioplasty of one major artery or branch. It uses a catheter-based approach rather than thoracotomy and TMR.
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 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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