No office rate
Use 33750 when the shunt originates from the subclavian artery. This code describes a central prosthetic-graft configuration.
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CMS RVU26D · Effective 2026-10-01
33764 Systemic-pulmonary shunt Medicare reimbursement rates in Tennessee
Reports creation of a central systemic-to-pulmonary artery shunt using a prosthetic graft, typically to increase pulmonary blood flow in congenital heart disease. Compare 33764 office and facility rates across CMS payment localities in Tennessee.
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 33764 in Tennessee?
Tennessee has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1145.39
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
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.
Congenital cardiac surgery
About 33764: Central systemic-to-pulmonary shunt with graft
Reports creation of a central systemic-to-pulmonary artery shunt using a prosthetic graft, typically to increase pulmonary blood flow in congenital heart disease.
A congenital cardiac surgeon creates a central connection from the systemic arterial circulation to the pulmonary artery using a prosthetic graft. The shunt provides additional pulmonary blood flow, often as palliation for a cyanotic congenital heart defect with inadequate flow to the lungs. The procedure is performed in an operating room; the operative report should identify the shunt’s origin and insertion and confirm use of a prosthetic graft.
Select this code for the central graft configuration, rather than choosing by the general goal of increasing pulmonary blood flow alone. Document the anatomy and construction so the central route can be distinguished from named subclavian or aortic shunt routes. This major surgery 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 one session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 33764
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU22.04 · 58%
- Practice expense (office) RVU10.20 · 27%
- Malpractice RVU5.55 · 15%
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.
33764 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
33755 identifies an ascending aorta-to-pulmonary artery shunt. Choose this code for the central graft configuration rather than that named route.
No office rate
33762 identifies a descending aorta-to-pulmonary artery shunt. The central prosthetic-graft configuration is reported with this code.
No office rate
33766 is a superior vena cava-to-pulmonary artery shunt for one lung, not a systemic arterial-to-pulmonary artery graft shunt.
Compare 33764 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.
1 of 1 payment localities
Tennessee →
Office / nonfacility
Unavailable
Facility
$1145.39
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33764 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
4,055
- Code
- 33764
- Physician work
- 22.04
- Practice expense
- 10.20
- Malpractice
- 5.55
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.04 | × 1.000 | 22.0400 |
| Practice expense | 10.20 | × 0.909 | 9.2718 |
| Malpractice | 5.55 | × 0.537 | 2.9804 |
| Total RVUs | 34.2921 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$1145.39
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.04 | 1 |
| Practice expense | 10.2 | 0.909 |
| Malpractice | 5.55 | 0.537 |
(22.04 × 1 + 10.2 × 0.909 + 5.55 × 0.537) × $33.4009 = $1145.39
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
33764 billing questions
How is this distinguished from a subclavian-to-pulmonary artery shunt?
This code is for the central shunt configuration using a prosthetic graft. A shunt originating from the subclavian artery is reported with 33750.
What operative details support code selection?
The report should establish the central route, identify the systemic arterial origin and pulmonary artery insertion, and document the prosthetic graft.
Can modifier 50 be used for a bilateral shunt?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only with 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 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.
4,05233750,,Shunt subclavian to pulm art,A,,21.66,8.62,NA,8.62,,5.45,35.73,35.73,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05333755,,Shunt as-aort to pulm art,A,,22.04,10.20,NA,10.20,,5.55,37.79,37.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05433762,,Shunt desc aorta to pulm art,A,,22.04,8.69,NA,8.69,,5.55,36.28,36.28,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05533764,,Shunt central w/prostc graft,A,,22.04,10.20,NA,10.20,,5.55,37.79,37.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05633766,,Shunt supr v/c p-art 1 lung,A,,22.98,8.88,NA,8.88,,5.78,37.64,37.64,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05733767,,Shunt supr v/c p-art bth lng,A,,24.67,9.21,NA,9.21,,6.21,40.09,40.09,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05833768,,Anast cavopulm sec sup v/c,A,,7.80,1.54,NA,1.54,,1.96,11.30,11.30,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780