Billing code 33518: CABG graftsMedicare rate & RVUs in Washington
Add-on reporting for coronary bypass surgery using two venous grafts together with one or more arterial grafts.
CMS doesn’t publish an office rate for 33518 in Washington.
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 33518 covers
This add-on represents the venous-graft portion of coronary artery bypass surgery when the operation also uses an arterial graft. A cardiac surgeon typically performs the bypass in a hospital operating room, using venous conduit such as saphenous vein to route blood around coronary artery blockages alongside an arterial conduit such as an internal mammary artery. The code is selected for two venous grafts; it does not represent two total grafts or the arterial graft count.
Report 33518 with the primary arterial CABG code that reflects the number of arterial grafts. The operative report should identify the arterial and venous conduits and document the number of each used. As an add-on, 33518 is billed only with a primary procedure and is paid within that procedure’s global period; it is not a stand-alone CABG report. The venous graft count determines this add-on level, while the arterial graft count determines the primary code.
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 33518 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $364.61 |
| Seattle (King Cnty) | Unavailable | $386.74 |
How the 33518 rate is calculated
Each of 33518’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 · 33518
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.73Practice expense 1.55Malpractice 1.91
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33518
The CMS indicators that decide how 33518 is paid alongside other services.
CMS payment indicators · 33518
CABG grafts
| 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) | 0 | Not permitted. |
| 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
33518 without 80 · national facility
$373.76
CABG grafts
33518-80 · Assistant: 16%
$59.80
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
33518 compared with similar codes
Compare codes
33518 vs 33517 vs 33519 vs 33511 vs 33533: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33517Combined CABG
- Both codes represent venous grafting with arterial CABG. Choose 33517 for one venous graft and 33518 for two.
- 33519CABG grafts
- Both are mixed arterial-and-venous CABG add-ons. Choose 33519 when three venous grafts are documented rather than two.
- 33511Coronary bypass
- 33511 represents two venous grafts without the mixed arterial-and-venous coding structure. Use 33518 when arterial grafting is also performed and the primary arterial CABG code is reported.
- 33533Arterial CABG
- 33533 is the primary CABG code for one arterial graft. It does not capture the two venous grafts represented by add-on code 33518.
33518 billing questions
Does 33518 mean two total bypass grafts?
No. It represents two venous grafts used with arterial grafting. The primary arterial CABG code reflects the arterial graft count.
Which primary code is reported with 33518?
Report the arterial CABG code for the number of arterial grafts, such as 33533 for one arterial graft or 33534 for two.
How does 33518 differ from 33511?
33518 is for two venous grafts used with arterial grafting. 33511 represents two venous grafts without the arterial-graft combination represented by 33518.
What documentation supports the two-graft level?
The operative report should identify the graft types and document two venous grafts, along with the arterial grafting that supports the primary CABG code.
Can 33518 be reported by itself?
No. It is an add-on code reported with the primary arterial CABG procedure and is paid within that 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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