Billing code 33020: PericardiotomyMedicare rate & RVUs in Texas
Reports surgical opening of the pericardium to remove a clot or foreign body, including cases performed with or without cardiopulmonary bypass.
CMS doesn’t publish an office rate for 33020 in Texas.
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 33020 covers
A cardiac or thoracic surgeon opens the pericardium to remove a clot or foreign body, such as retained material causing compression around the heart. This is an operative service, commonly performed in a hospital operating room when the problem requires direct surgical access rather than needle or catheter drainage. The procedure may be performed with or without cardiopulmonary bypass.
Report the code when the operative record supports pericardial incision for clot or foreign-body removal; a pericardial window for effusion or pericardial tissue resection is a different service. The major-surgery global period includes 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. An assistant at surgery may be paid; co-surgeons require 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.
Where 33020 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $783.35 |
| Beaumont | Unavailable | $757.16 |
| Brazoria | Unavailable | $760.42 |
| Dallas | Unavailable | $770.79 |
| Fort Worth | Unavailable | $770.23 |
| Galveston | Unavailable | $766.30 |
| Houston | Unavailable | $828.71 |
| Rest Of Texas | Unavailable | $762.15 |
How the 33020 rate is calculated
Each of 33020’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 · 33020
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.95Practice expense 6.10Malpractice 3.41
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33020
33020 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33020
Pericardiotomy
| 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 · 33020
Pericardiotomy
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
33020 without 51 · national facility
$783.59
Pericardiotomy
33020-51 · Second procedure: 50%
$391.80
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%).
33020 compared with similar codes
Compare codes
33020 vs 33016 vs 33017 vs 33025: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33016Pericardiocentesis
- 33020 involves surgical access to remove a clot or foreign body. 33016 is image-guided needle drainage of pericardial fluid.
- 33017Pericardial drainage
- 33017 provides catheter-based pericardial drainage for the specified age and congenital-anomaly group. 33020 is an operative incision for clot or foreign-body removal.
- 33025Pericardial window
- 33025 creates a pericardial window or partially resects tissue for drainage. Use 33020 when the operation is for removal of a clot or foreign body.
33020 billing questions
How does this differ from pericardiocentesis?
This code is for surgical pericardial access to remove a clot or foreign body. Pericardiocentesis uses needle or catheter access to drain pericardial fluid.
Is a pericardial window reported with this code?
A window created to provide drainage is a distinct service, generally represented by 33025. Choose based on the operation documented, not simply the fact that the pericardium was opened.
What documentation supports reporting 33020?
The operative report should establish the pericardial incision and removal of a clot or foreign body. It should also describe the operative approach and whether cardiopulmonary bypass was used.
Can modifier 50 be used?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are subject to reduction. The code has a 90-day global period for related postoperative care.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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 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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