Billing code 33745: Intracardiac shuntMedicare rate & RVUs in Oklahoma
Report this code for transcatheter creation of the first intracardiac shunt to manage a congenital cardiac anomaly, with imaging guidance included when performed.
CMS doesn’t publish an office rate for 33745 in Oklahoma.
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 33745 covers
A congenital interventional cardiologist creates an intentional blood-flow pathway within the heart using a transcatheter approach to address a congenital cardiac anomaly. The service is generally performed in a hospital catheterization laboratory, with imaging guidance included when performed. This code identifies the first shunt created; it is distinct from a transcatheter atrial septostomy and from an extracardiac surgical shunt between a systemic artery and the pulmonary artery.
Report the first shunt under 33745 and use 33746 for each additional shunt when supported by the procedure performed. The operative or catheterization report should establish the congenital anomaly, the shunt created, and whether additional shunts were created. The code has a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. 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.
33745 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $881.35 |
How the 33745 rate is calculated
Each of 33745’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 · 33745
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.50Practice expense 3.64Malpractice 4.68
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33745
The CMS indicators that decide how 33745 is paid alongside other services.
CMS payment indicators · 33745
Intracardiac shunt
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33745 without 51 · national facility
$929.21
Intracardiac shunt
33745-51 · Second procedure: 50%
$464.61
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%).
33745 compared with similar codes
Compare codes
33745 vs 33746 vs 33741 vs 33750: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33746Intracardiac shunt
- 33745 is for the first shunt. Use 33746 for each additional shunt created during the procedure when documented.
- 33741Atrial septostomy
- 33741 describes transcatheter atrial septostomy for a congenital cardiac anomaly. Choose 33745 when the service creates an intracardiac shunt rather than performing atrial septostomy.
- 33750Systemic-to-pulmonary shunt
- 33750 describes a surgical shunt from the subclavian artery to the pulmonary artery. It is not the transcatheter intracardiac shunt service reported with 33745.
33745 billing questions
When should 33745 be reported instead of 33741?
Use 33745 for creation of an intracardiac shunt. Code 33741 describes transcatheter atrial septostomy for a congenital cardiac anomaly; select based on the procedure actually performed.
How is a second shunt reported?
Report 33745 for the first shunt and 33746 for each additional shunt created, when the procedure documentation supports the additional service.
Is imaging guidance separately reported?
Imaging guidance is included when performed as part of the service described by 33745; do not separately report it as though it were outside this procedure.
Can modifier 50 be used for bilateral work?
No. Modifier 50 is inappropriate for this code because the descriptor or anatomy does not support a bilateral adjustment.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. The code has a 0-day 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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