Billing code 33645: Pulmonary vein repairMedicare rate & RVUs in Oregon
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.
CMS doesn’t publish an office rate for 33645 in Oregon.
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 33645 covers
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.
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.
Where 33645 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,606.79 |
| Rest Of Oregon | Unavailable | $1,540.62 |
How the 33645 rate is calculated
Each of 33645’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 · 33645
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 30.52Practice expense 10.24Malpractice 7.69
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33645
33645 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33645
Pulmonary vein repair
| 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 · 33645
Pulmonary vein repair
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
33645 without 51 · national facility
$1,618.27
Pulmonary vein repair
33645-51 · Second procedure: 50%
$809.14
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%).
33645 compared with similar codes
Compare codes
33645 vs 33641 vs 33647 vs 33622: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33641ASD repair
- This code addresses anomalous pulmonary venous return. Code 33641 is for a septal defect repair; select based on the operative work documented.
- 33647Atrial septal repair
- 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.
- 33622Congenital heart surgery
- 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.
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 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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