Billing code 33924: Shunt removalMedicare rate & RVUs in Texas
Reports removal of a prior systemic-to-pulmonary artery shunt during congenital heart surgery, in addition to the primary operation.
CMS doesn’t publish an office rate for 33924 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 33924 covers
This service removes a surgically created connection that directs blood from a systemic artery to the pulmonary arteries. A typical example is removal of a prior Blalock-Taussig-type shunt during a later operation to repair congenital heart disease. A congenital cardiac surgeon generally performs the removal in the operating room as part of the larger heart operation; it is not a stand-alone shunt procedure.
Report 33924 only with an eligible primary procedure, such as a pulmonary atresia repair or pulmonary artery unifocalization when the shunt is also removed. The operative report should identify the existing shunt, document its removal, and describe the primary operation performed. CMS treats this as an add-on: payment is included within the primary procedure’s global period. The add-on should not be submitted by itself.
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 33924 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 | $255.87 |
| Beaumont | Unavailable | $252.18 |
| Brazoria | Unavailable | $249.86 |
| Dallas | Unavailable | $253.68 |
| Fort Worth | Unavailable | $253.90 |
| Galveston | Unavailable | $252.06 |
| Houston | Unavailable | $276.41 |
| Rest Of Texas | Unavailable | $252.41 |
How the 33924 rate is calculated
Each of 33924’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 · 33924
RVUs × geographic indexes × conversion factor
Work5.35
5.35 RVUs× 1.000 GPCI
Practice expense1.06
1.06 RVUs× 1.000 GPCI
Malpractice1.33
1.33 RVUs× 1.000 GPCI
Adjusted RVUs
7.7400
Conversion factor
$33.4009
Medicare rate
$258.52
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33924
The CMS indicators that decide how 33924 is paid alongside other services.
CMS payment indicators · 33924
Shunt removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
33924 without 80 · national facility
$258.52
Shunt removal
33924-80 · Assistant: 16%
$41.36
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
33924 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33920Congenital heart repair
- 33920 describes the pulmonary atresia repair itself. Code 33924 is additional and applies only when a prior systemic-to-pulmonary shunt is removed during the operation.
- 33922Pulmonary artery surgery
- 33922 describes transection of a pulmonary artery for a congenital heart defect; 33924 describes removal of a previously created systemic-to-pulmonary shunt.
- 33925Pulmonary artery repair
- 33925 describes pulmonary artery unifocalization without cardiopulmonary bypass. It is a primary reconstructive service, not the shunt-removal work represented by 33924.
- 33926Pulmonary artery repair
- 33926 describes pulmonary artery unifocalization with cardiopulmonary bypass. Use 33924 only for additional removal of a prior systemic-to-pulmonary shunt.
33924 billing questions
Can 33924 be billed by itself?
No. It is an add-on for removal of an existing systemic-to-pulmonary shunt during a primary operation, and must be reported with that operation.
How is 33924 different from 33920?
33920 represents the main repair for pulmonary atresia. Report 33924 in addition only when a prior systemic-to-pulmonary shunt is also removed.
What documentation supports reporting 33924?
The operative note should identify the prior shunt and describe its removal, alongside the primary congenital heart operation.
Is payment for 33924 separate from the primary procedure’s global period?
No. CMS identifies 33924 as an add-on paid within the primary 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 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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