No office rate
Both cover extensive atrial ablation, but 33255 is for work without cardiopulmonary bypass; 33256 includes bypass.
On this page
CMS RVU26D · Effective 2026-10-01
33256 Atrial ablation Medicare reimbursement rates in Wyoming
Reports extensive surgical ablation and atrial reconstruction, such as a maze procedure, when performed with cardiopulmonary bypass. Compare 33256 office and facility rates across CMS payment localities in Wyoming.
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 33256 in Wyoming?
Wyoming 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
$1756.25
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 33256: Extensive atrial ablation with bypass
Reports extensive surgical ablation and atrial reconstruction, such as a maze procedure, when performed with cardiopulmonary bypass.
This code describes extensive surgical ablation and reconstruction of atrial tissue, commonly performed to treat atrial fibrillation with a maze-type lesion pattern. A cardiothoracic surgeon performs the open operation in a hospital setting using cardiopulmonary bypass. The operative report should establish the extent of the atrial work and document bypass use; a limited lesion set or an operation performed without bypass points to a different code in the family.
Report the service for the atrial ablation itself, with documentation of the lesion pattern, operative approach, and bypass. It may be performed during a broader cardiac operation, but the standard multiple-procedure reduction applies when other procedures are performed in the same session: the highest-valued procedure is paid in full and the others at 50%. The 90-day global includes the day-before preoperative visit and related postoperative care during the period. Report the atrial work as one operation rather than using modifier 50. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 33256
- 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 RVU34.03 · 62%
- Practice expense (office) RVU12.52 · 23%
- Malpractice RVU8.15 · 15%
81
Medicare services in 2024 · #5039 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.
33256 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
33254 is for limited atrial ablation without bypass. 33256 requires extensive work performed with bypass.
No office rate
33266 describes extensive endoscopic atrial ablation. 33256 describes extensive open surgical work with cardiopulmonary bypass.
Compare 33256 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$1756.25
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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 33256 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,879
- Code
- 33256
- Physician work
- 34.03
- Practice expense
- 12.52
- Malpractice
- 8.15
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 34.03 | × 1.000 | 34.0300 |
| Practice expense | 12.52 | × 1.000 | 12.5200 |
| Malpractice | 8.15 | × 0.740 | 6.0310 |
| Total RVUs | 52.5810 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1756.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 34.03 | 1 |
| Practice expense | 12.52 | 1 |
| Malpractice | 8.15 | 0.74 |
(34.03 × 1 + 12.52 × 1 + 8.15 × 0.74) × $33.4009 = $1756.25
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.
33256 billing questions
How is 33256 distinguished from 33255?
Both describe extensive atrial ablation, but 33256 is performed with cardiopulmonary bypass. Code 33255 is for extensive work without bypass.
When should a limited ablation code be considered?
Choose a limited code when the operative report supports a limited lesion set rather than extensive atrial ablation and reconstruction. Bypass use also affects which code applies.
Can 33256 be reported with another cardiac procedure?
It may be performed during the same session as another cardiac operation. The standard multiple-procedure reduction applies: the highest-valued procedure is paid in full and the others at 50%.
What documentation supports reporting 33256?
The operative report should describe the extent and pattern of atrial ablation or reconstruction and document cardiopulmonary bypass use.
What does the 90-day global include?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can assistant or co-surgeon services be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment 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 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.
3,87633251,,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
3,88133258,,Ablate atria x10sv add-on,A,,10.73,5.75,NA,5.75,,2.57,19.05,19.05,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88233259,,Ablate atria w/bypass add-on,A,,13.79,7.43,NA,7.43,,3.36,24.58,24.58,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,