Billing code 33265: Atrial ablationMedicare rate & RVUs in Rhode Island
Reports limited surgical ablation for atrial fibrillation performed endoscopically without cardiopulmonary bypass, typically using a thoracoscopic approach to create an epicardial lesion set.
CMS doesn’t publish an office rate for 33265 in Rhode Island.
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 33265 covers
A cardiothoracic surgeon performs this limited surgical ablation through an endoscopic, typically thoracoscopic, approach without cardiopulmonary bypass. The surgeon accesses the atria from outside the heart and creates lesions intended to interrupt atrial fibrillation, commonly including pulmonary vein isolation. It is distinct from catheter-based ablation performed inside the heart and from more extensive surgical lesion sets.
Select the code when the operative report supports a limited endoscopic ablation performed without bypass; document the approach, lesion set, and whether bypass was used. The code has a 90-day global period, including the day-before preoperative visit and 90 days of 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 multiple-procedure reduction. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.
33265 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | Unavailable | $1,299.39 |
How the 33265 rate is calculated
Each of 33265’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 · 33265
RVUs × geographic indexes × conversion factor
Work23.12
23.12 RVUs× 1.000 GPCI
Practice expense9.94
9.94 RVUs× 1.000 GPCI
Malpractice5.69
5.69 RVUs× 1.000 GPCI
Adjusted RVUs
38.7500
Conversion factor
$33.4009
Medicare rate
$1,294.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33265
33265 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33265
Atrial ablation
| 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 · 33265
Atrial ablation
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
33265 without 51 · national facility
$1,294.28
Atrial ablation
33265-51 · Second procedure: 50%
$647.14
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%).
33265 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33266Atrial ablation
- Both are endoscopic surgical ablations without bypass; 33265 represents limited ablation, while 33266 represents extensive ablation.
- 33254Atrial ablation
- This code describes limited surgical atrial ablation without bypass using a different approach. Use 33265 when the operative service is endoscopic.
- 33255Atrial ablation
- 33255 describes limited surgical atrial ablation with cardiopulmonary bypass; 33265 is the endoscopic limited service without bypass.
33265 billing questions
How is 33265 distinguished from 33266?
Both describe endoscopic surgical ablation without cardiopulmonary bypass. Choose 33265 for a limited lesion set and 33266 when the documented surgical ablation is extensive.
How does 33265 differ from 33254?
The key distinction is the endoscopic approach represented by 33265. Use the code that matches the operative approach and documented extent of ablation.
What documentation supports the limited service?
The operative report should identify the endoscopic approach, the ablation performed and its extent, and whether cardiopulmonary bypass was used.
Can modifier 50 be reported?
No. The descriptor and anatomy make this a nonbilateral service, so modifier 50 is inappropriate.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be paid for this procedure?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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