No office rate
Use 33750 for a subclavian-source shunt. Code 33755 describes an aorta-to-pulmonary-artery route.
On this page
CMS RVU26D · Effective 2026-10-01
33750 Systemic-to-pulmonary shunt Medicare reimbursement rates in Wyoming
Reports a palliative congenital heart operation connecting the subclavian artery with a pulmonary artery to increase pulmonary blood flow in selected patients. Compare 33750 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 33750 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
$1146.09
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.
Congenital cardiac surgery
About 33750: Subclavian-to-pulmonary artery shunt
Reports a palliative congenital heart operation connecting the subclavian artery with a pulmonary artery to increase pulmonary blood flow in selected patients.
The surgeon creates a connection from the subclavian artery to a pulmonary artery to augment blood flow to the lungs. This palliative operation is used for selected congenital heart conditions with inadequate pulmonary blood flow, including some forms of pulmonary atresia or tetralogy of Fallot. It is generally performed by a congenital cardiothoracic surgeon in an operating room, often for an infant or child awaiting further repair or as part of a staged treatment plan.
Report the procedure when the operative record supports the subclavian-to-pulmonary-artery route; the congenital diagnosis alone does not establish this code. Documentation should identify the vessels connected and describe the shunt performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33750
- 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 RVU21.66 · 61%
- Practice expense (office) RVU8.62 · 24%
- Malpractice RVU5.45 · 15%
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.
33750 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
This code is specific to a subclavian source; 33762 identifies the descending aorta as the source.
No office rate
33764 is for a central shunt with a prosthetic graft. Choose 33750 when the documented shunt uses the subclavian-to-pulmonary-artery route.
Compare 33750 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
$1146.09
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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 33750 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,052
- Code
- 33750
- Physician work
- 21.66
- Practice expense
- 8.62
- Malpractice
- 5.45
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.66 | × 1.000 | 21.6600 |
| Practice expense | 8.62 | × 1.000 | 8.6200 |
| Malpractice | 5.45 | × 0.740 | 4.0330 |
| Total RVUs | 34.3130 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1146.09
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.66 | 1 |
| Practice expense | 8.62 | 1 |
| Malpractice | 5.45 | 0.74 |
(21.66 × 1 + 8.62 × 1 + 5.45 × 0.74) × $33.4009 = $1146.09
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.
33750 billing questions
How is this distinguished from an aorta-to-pulmonary artery shunt?
Select this code when the subclavian artery is the systemic source for the shunt. A shunt originating from the aorta is represented by a different code.
What operative documentation supports this code?
The operative report should identify the subclavian artery and pulmonary artery as the connected vessels and describe the shunt performed.
Can modifier 50 be used for shunts to both lungs?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the procedure supported by the documented operative anatomy rather than adding modifier 50.
Is an assistant surgeon payable?
CMS indicates that assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through the 90-day 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 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.
4,04933745,,Tis cgen car anomal 1st shnt,A,,19.50,3.64,NA,3.64,,4.68,27.82,27.82,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05033746,,Tis cgen car anomal ea addl,A,,7.80,1.45,NA,1.45,,1.86,11.11,11.11,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0513374F,,Ajcc brst cncr stage 1 docd,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
4,05233750,,Shunt subclavian to pulm art,A,,21.66,8.62,NA,8.62,,5.45,35.73,35.73,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05333755,,Shunt as-aort to pulm art,A,,22.04,10.20,NA,10.20,,5.55,37.79,37.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05433762,,Shunt desc aorta to pulm art,A,,22.04,8.69,NA,8.69,,5.55,36.28,36.28,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05533764,,Shunt central w/prostc graft,A,,22.04,10.20,NA,10.20,,5.55,37.79,37.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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.,,,,,,