No office rate
This code addresses anomalous pulmonary venous return. Code 33641 is for a septal defect repair; select based on the operative work documented.
On this page
CMS RVU26D · Effective 2026-10-01
33645 Pulmonary vein repair Medicare reimbursement rates in Ohio
Reports open surgical correction of partial or total anomalous pulmonary venous return by rerouting the abnormal drainage to restore pulmonary venous flow to the heart. Compare 33645 office and facility rates across CMS payment localities in Ohio.
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 33645 in Ohio?
Ohio 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
$1590.57
1 of 1 localities have a supported rate.
Payment area: Ohio
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 cardiac surgery
About 33645: Anomalous pulmonary vein rerouting
Reports open surgical correction of partial or total anomalous pulmonary venous return by rerouting the abnormal drainage to restore pulmonary venous flow to the heart.
This open-heart operation corrects congenital pulmonary veins that drain abnormally rather than returning blood to the left atrium. A congenital cardiac surgeon reroutes the affected venous drainage, typically using cardiopulmonary bypass. The operation is performed in a hospital operating room for patients with partial or total anomalous pulmonary venous return; the operative report identifies the abnormal connection and the repair performed.
Select this code when the documented operation addresses the anomalous pulmonary venous return, rather than an isolated septal defect or a broader redo congenital repair. Documentation should describe the anomalous veins, their drainage site, and the rerouting performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same 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, and team surgery is not permitted. Modifier 50 is inappropriate for this procedure.
CMS billing rules for 33645
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU30.52 · 63%
- Practice expense (office) RVU10.24 · 21%
- Malpractice RVU7.69 · 16%
34
Medicare services in 2024 · #5582 by national volume
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.
33645 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
Use this code for pulmonary venous rerouting. Code 33647 describes a septal defect repair, so it is not selected solely because a septal defect is present.
No office rate
This code is specific to anomalous pulmonary venous return repair. Code 33622 is the redo-complex-anomaly option when the documented operation is reported as a broader redo repair.
Compare 33645 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
Ohio →
Office / nonfacility
Unavailable
Facility
$1590.57
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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 33645 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
4,022
- Code
- 33645
- Physician work
- 30.52
- Practice expense
- 10.24
- Malpractice
- 7.69
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 30.52 | × 1.000 | 30.5200 |
| Practice expense | 10.24 | × 0.913 | 9.3491 |
| Malpractice | 7.69 | × 1.008 | 7.7515 |
| Total RVUs | 47.6206 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$1590.57
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 30.52 | 1 |
| Practice expense | 10.24 | 0.913 |
| Malpractice | 7.69 | 1.008 |
(30.52 × 1 + 10.24 × 0.913 + 7.69 × 1.008) × $33.4009 = $1590.57
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.
33645 billing questions
When should this code be selected instead of an atrial septal defect repair code?
Use this code when the operation surgically redirects anomalous pulmonary venous drainage. An atrial septal defect code describes a septal repair when that is the operative target; review the full operative report when both abnormalities are addressed.
Does the 90-day global period include postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures performed in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can modifier 50 be used for right- and left-sided pulmonary veins?
No. Modifier 50 is inappropriate for this procedure; the repair is reported as a single cardiac operation, not as a bilateral service.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What operative details support reporting this code?
Document the anomalous venous drainage, the veins and drainage site involved, and the surgical rerouting performed. The record should make clear that the operation corrected anomalous pulmonary venous return.
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.
4,01933621,,Transthor cath for stent,A,,15.78,6.75,NA,6.75,,3.97,26.50,26.50,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02033622,,Redo compl cardiac anomaly,A,,62.40,16.44,NA,16.44,,15.74,94.58,94.58,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02133641,,Repair heart septum defect,A,,28.84,9.81,NA,9.81,,7.28,45.93,45.93,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02233645,,Revision of heart veins,A,,30.52,10.24,NA,10.24,,7.69,48.45,48.45,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02333647,,Repair heart septum defects,A,,32.18,10.46,NA,10.46,,8.11,50.75,50.75,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02433660,,Repair of heart defects,A,,31.03,10.25,NA,10.25,,7.83,49.11,49.11,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02533665,,Repair of heart defects,A,,33.98,10.82,NA,10.82,,8.58,53.38,53.38,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703