Billing code 33767: Cavopulmonary shuntMedicare rate & RVUs in Washington
Reports congenital heart surgery connecting superior vena caval blood flow to the pulmonary arteries serving both lungs, commonly as single-ventricle palliation.
CMS doesn’t publish an office rate for 33767 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 33767 covers
A congenital cardiac surgeon creates a pathway from the superior vena cava to the pulmonary arteries so venous blood flows to both lungs. This is commonly a bidirectional Glenn-type operation in staged palliation for selected patients with single-ventricle physiology. It is performed in an operating room, generally by a congenital heart surgery team.
Choose this code when the operative report supports a superior vena cava-to-pulmonary artery shunt serving both lungs; the one-lung version is a different code. Documentation should identify the vessels connected and the extent of the shunt. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment 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 33767 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,316.48 |
| Seattle (King Cnty) | Unavailable | $1,412.11 |
How the 33767 rate is calculated
Each of 33767’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 · 33767
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 24.67Practice expense 9.21Malpractice 6.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33767
33767 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33767
Cavopulmonary shunt
| 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 · 33767
Cavopulmonary shunt
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
33767 without 51 · national facility
$1,339.04
Cavopulmonary shunt
33767-51 · Second procedure: 50%
$669.52
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%).
33767 compared with similar codes
Compare codes
33767 vs 33766 vs 33750 vs 33764: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33766Glenn shunt
- Use 33766 when the superior vena cava-to-pulmonary artery shunt serves one lung; this code is for a shunt serving both lungs.
- 33750Systemic-to-pulmonary shunt
- 33750 describes a shunt from the subclavian artery to the pulmonary artery. This code connects the superior vena cava to the pulmonary arteries.
- 33764Systemic-pulmonary shunt
- 33764 describes a central shunt with a prosthetic graft. This code describes a cavopulmonary shunt serving both lungs.
33767 billing questions
How does this differ from 33766?
33767 describes the superior vena cava-to-pulmonary artery shunt serving both lungs. Use 33766 when the documented shunt serves one lung.
Should modifier 50 be appended because both lungs are involved?
No. The bilateral anatomy is built into this code, and CMS identifies modifier 50 as inappropriate.
What operative documentation supports this code?
The operative report should identify the superior vena cava and pulmonary artery connections and show that the shunt serves both lungs.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
Does the code include related postoperative care?
Yes. Its 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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