Billing code 33746: Intracardiac shuntMedicare rate & RVUs in Ohio
Report 33746 for each additional intracardiac shunt created by stent placement during a congenital heart catheterization, alongside the initial-shunt code.
CMS doesn’t publish an office rate for 33746 in Ohio.
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 33746 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $367.37 |
How the 33746 rate is calculated
Each of 33746’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 · 33746
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.80Practice expense 1.45Malpractice 1.86
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33746
The CMS indicators that decide how 33746 is paid alongside other services.
CMS payment indicators · 33746
Intracardiac shunt
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
33746 without 80 · national facility
$371.08
Intracardiac shunt
33746-80 · Assistant: 16%
$59.37
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
33746 compared with similar codes
Compare codes
33746 vs 33745 vs 33741 vs 33750: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33745Intracardiac shunt
- 33745 reports the initial stent-created intracardiac shunt and is required with 33746. Use 33746 for each additional shunt created in the same procedure.
- 33741Atrial septostomy
- 33741 describes transcatheter atrial septostomy; 33746 applies to an additional intracardiac shunt created by stent placement with 33745.
- 33750Systemic-to-pulmonary shunt
- 33750 describes a surgical shunt from the subclavian artery to the pulmonary artery, not an additional transcatheter intracardiac shunt.
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 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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