No office rate
Use 33257 for limited atrial ablation with bypass; 33256 represents extensive atrial work with bypass.
On this page
CMS RVU26D · Effective 2026-10-01
33257 Atrial ablation Medicare reimbursement rates in Pennsylvania
Reports limited surgical ablation of atrial tissue during another cardiac operation that uses cardiopulmonary bypass, as an add-on service. Compare 33257 office and facility rates across CMS payment localities in Pennsylvania.
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 33257 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$550.30–$597.10
2 of 2 localities have a supported rate.
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.
Cardiac surgery
About 33257: Limited atrial ablation with bypass
Reports limited surgical ablation of atrial tissue during another cardiac operation that uses cardiopulmonary bypass, as an add-on service.
A cardiac surgeon performs a limited set of lesion-forming or reconstructive steps on atrial tissue during another cardiac operation that uses cardiopulmonary bypass. The service is commonly considered when atrial fibrillation is addressed during open cardiac surgery, such as a valve operation. The operative report should distinguish the atrial ablation from the primary cardiac procedure and describe the work performed.
Report 33257 only with a qualifying primary procedure from the same operative session; it is not a stand-alone service. Select the limited-extent code when the documented lesion work is limited rather than extensive, and confirm that cardiopulmonary bypass was used. CMS identifies this as an add-on code and handles its payment within the primary procedure's global period. The operative documentation should support the atrial work, its extent, bypass use, and the related primary operation.
CMS billing rules for 33257
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU9.39 · 55%
- Practice expense (office) RVU5.32 · 31%
- Malpractice RVU2.33 · 14%
6K
Medicare services in 2024 · #1761 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.
33257 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
33259 is the add-on option for extensive atrial ablation with bypass; 33257 is for limited work.
No office rate
33258 describes extensive atrial ablation without bypass, while 33257 is limited work performed with bypass.
No office rate
33265 describes limited atrial ablation performed endoscopically; 33257 is the limited add-on option associated with cardiopulmonary bypass.
Compare 33257 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$597.10
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$550.30
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33257 billing questions
Can 33257 be reported by itself?
No. It is an add-on code and must be reported with a qualifying primary cardiac procedure performed in the same operative session.
How is 33257 different from 33256?
Both describe atrial ablation with cardiopulmonary bypass, but 33257 is for limited work and 33256 is for extensive work.
What documentation supports 33257?
The operative report should identify the atrial ablation, describe its limited extent, document cardiopulmonary bypass, and identify the primary cardiac procedure performed in the session.
Is the ablation reported by lesion count?
Choose the code by the documented extent of the atrial work, not by treating each lesion as a separate service.
How does CMS handle payment for this add-on?
CMS treats 33257 as an add-on reported with a primary procedure and places its payment within that procedure's global period.
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.
3,87733254,,Ablate atria lmtd,A,,23.12,9.92,NA,9.92,,5.68,38.72,38.72,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87833255,,Ablate atria w/o bypass ext,A,,28.31,11.34,NA,11.34,,6.77,46.42,46.42,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87933256,,Ablate atria w/bypass exten,A,,34.03,12.52,NA,12.52,,8.15,54.70,54.70,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88033257,,Ablate atria lmtd add-on,A,,9.39,5.32,NA,5.32,,2.33,17.04,17.04,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88133258,,Ablate atria x10sv add-on,A,,10.73,5.75,NA,5.75,,2.57,19.05,19.05,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88233259,,Ablate atria w/bypass add-on,A,,13.79,7.43,NA,7.43,,3.36,24.58,24.58,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8833325F,,Preop asses 4 cataract surg,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00