Billing code 33606: Cardiac anastomosisMedicare rate & RVUs in Nevada
Reports an operative connection between a pulmonary artery and the aorta to increase pulmonary blood flow in selected congenital heart conditions.
CMS doesn’t publish an office rate for 33606 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 33606 covers
This open congenital heart operation creates a connection between a pulmonary artery and the aorta to direct systemic blood into the pulmonary circulation. It may be used as palliation for selected cyanotic congenital heart defects when pulmonary blood flow is inadequate. A congenital cardiac surgeon typically performs the procedure in a hospital operating room; the operative report should identify the vessels connected and the specific repair performed.
Report 33606 when the documented operation matches this direct arterial connection, rather than a differently configured systemic-to-pulmonary shunt or a repair of the underlying defect. The operative note should support the indication, anatomy, and work performed, and identify any other cardiac procedures done during 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Modifier 50 is not appropriate for this anatomy, and team-surgery billing 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.
33606 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $1,634.61 |
How the 33606 rate is calculated
Each of 33606’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 · 33606
RVUs × geographic indexes × conversion factor
Work30.74
30.74 RVUs× 1.000 GPCI
Practice expense11.74
11.74 RVUs× 1.000 GPCI
Malpractice7.74
7.74 RVUs× 1.000 GPCI
Adjusted RVUs
50.2200
Conversion factor
$33.4009
Medicare rate
$1,677.39
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33606
33606 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33606
Cardiac anastomosis
| 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 · 33606
Cardiac anastomosis
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
33606 without 51 · national facility
$1,677.39
Cardiac anastomosis
33606-51 · Second procedure: 50%
$838.70
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%).
33606 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33750Systemic-to-pulmonary shunt
- 33750 describes a subclavian-to-pulmonary artery shunt. Use 33606 for the pulmonary artery-to-aorta anastomosis documented in the operative report.
- 33755Systemic-pulmonary shunt
- 33755 identifies a central systemic-to-pulmonary shunt. Compare its defined configuration with the direct arterial anastomosis documented for 33606.
- 33762Systemic-to-pulmonary shunt
- 33762 describes another systemic-to-pulmonary shunt configuration. Select the code that matches the vessels and technique recorded by the surgeon.
33606 billing questions
How is 33606 distinguished from a systemic-to-pulmonary shunt code?
Choose 33606 when the operative report supports this direct pulmonary artery-to-aorta anastomosis. Other shunt codes describe different configurations, such as a subclavian-to-pulmonary artery connection.
What documentation supports reporting 33606?
The operative report should identify the congenital condition, the pulmonary artery and aortic anatomy, and the connection created. It should also describe any additional cardiac procedures performed during the session.
Can modifier 50 be used for this service?
No. The anatomy is not reported as a paired bilateral service, so modifier 50 is inappropriate.
Can an assistant surgeon or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted for this service.
How does the multiple-procedure reduction affect 33606?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care.
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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