No office rate
Both are surgical atrial ablation procedures without cardiopulmonary bypass. Choose 33254 for limited work and 33255 for extensive work.
On this page
CMS RVU26D · Effective 2026-10-01
33254 Atrial ablation Medicare reimbursement rates in Vermont
Reports a limited surgical ablation of atrial tissue for an arrhythmia, performed without cardiopulmonary bypass, such as during surgical treatment of atrial fibrillation. Compare 33254 office and facility rates across CMS payment localities in Vermont.
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 33254 in Vermont?
Vermont 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
$1196.25
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Cardiac surgery
About 33254: Limited atrial ablation without bypass
Reports a limited surgical ablation of atrial tissue for an arrhythmia, performed without cardiopulmonary bypass, such as during surgical treatment of atrial fibrillation.
A cardiac surgeon creates a limited pattern of lesions in atrial tissue to interrupt abnormal electrical pathways, most commonly as surgical treatment for atrial fibrillation. The work is performed in an operating room and may use surgical energy or tissue-cutting techniques. This code identifies an operation performed without cardiopulmonary bypass; it is not the catheter-based approach used for endocardial ablation.
Select the code based on the limited extent of the atrial ablation and the absence of bypass. The operative report should describe the arrhythmia being treated, the atrial lesion work and its extent, and whether cardiopulmonary bypass was used. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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 atrial procedure. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33254
- 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 RVU23.12 · 60%
- Practice expense (office) RVU9.92 · 26%
- Malpractice RVU5.68 · 15%
159
Medicare services in 2024 · #4516 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.
33254 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
This code describes limited surgical ablation with cardiopulmonary bypass; 33254 describes limited ablation without bypass.
No office rate
33265 describes a limited endoscopic approach. Use 33254 for the applicable non-endoscopic surgical approach without cardiopulmonary bypass.
Compare 33254 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
Vermont →
Office / nonfacility
Unavailable
Facility
$1196.25
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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 33254 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,877
- Code
- 33254
- Physician work
- 23.12
- Practice expense
- 9.92
- Malpractice
- 5.68
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.12 | × 1.000 | 23.1200 |
| Practice expense | 9.92 | × 0.990 | 9.8208 |
| Malpractice | 5.68 | × 0.506 | 2.8741 |
| Total RVUs | 35.8149 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$1196.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 23.12 | 1 |
| Practice expense | 9.92 | 0.99 |
| Malpractice | 5.68 | 0.506 |
(23.12 × 1 + 9.92 × 0.99 + 5.68 × 0.506) × $33.4009 = $1196.25
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.
33254 billing questions
How is 33254 distinguished from 33255?
Both describe surgical atrial ablation without cardiopulmonary bypass. Use 33254 for limited ablation and 33255 when the operative work is extensive.
What documentation supports the limited level?
The operative report should describe the atrial lesion pattern and extent, the arrhythmia treated, and whether cardiopulmonary bypass was used. The documented work should support a limited rather than extensive ablation.
Can modifier 50 be used for right and left atrial work?
No. Modifier 50 is inappropriate for this procedure; atrial ablation is not reported as a bilateral service.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when other 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.
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.
3,8743324F,,Mri ct scan ord rvwd rqstd,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
3,87533250,,Ablate heart dysrhythm focus,A,,25.25,10.37,NA,10.37,,6.05,41.67,41.67,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87633251,,Ablate heart dysrhythm focus,A,,28.20,10.60,NA,10.60,,7.10,45.90,45.90,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87733254,,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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817