No office rate
Choose 33750 when the shunt originates from the subclavian artery; choose 33755 for an ascending-aorta origin.
On this page
CMS RVU26D · Effective 2026-10-01
33755 Systemic-pulmonary shunt Medicare reimbursement rates in Wyoming
Reports surgical creation of a connection from the ascending aorta to the pulmonary artery to increase pulmonary blood flow in congenital heart disease. Compare 33755 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 33755 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
$1214.02
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 33755: Ascending aorta to pulmonary artery shunt
Reports surgical creation of a connection from the ascending aorta to the pulmonary artery to increase pulmonary blood flow in congenital heart disease.
This operation creates a systemic-to-pulmonary blood-flow connection from the ascending aorta to the pulmonary artery. A congenital or pediatric cardiac surgeon typically performs it in an operating room as palliation for congenital heart disease with inadequate pulmonary blood flow. The operative anatomy distinguishes this shunt from procedures using the subclavian artery, descending aorta, or a prosthetic central graft.
Report the code when the documented operation creates this connection; the operative report should identify the shunt’s origin and destination and describe the surgical work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33755
- 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 RVU22.04 · 58%
- Practice expense (office) RVU10.20 · 27%
- Malpractice RVU5.55 · 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.
33755 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
33762 identifies a descending-aorta origin. The ascending-aorta origin distinguishes 33755.
No office rate
33764 describes a central shunt with a prosthetic graft; 33755 is selected for the ascending-aorta-to-pulmonary-artery connection.
Compare 33755 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
$1214.02
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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 33755 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,053
- Code
- 33755
- Physician work
- 22.04
- Practice expense
- 10.20
- Malpractice
- 5.55
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.04 | × 1.000 | 22.0400 |
| Practice expense | 10.20 | × 1.000 | 10.2000 |
| Malpractice | 5.55 | × 0.740 | 4.1070 |
| Total RVUs | 36.3470 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1214.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.04 | 1 |
| Practice expense | 10.2 | 1 |
| Malpractice | 5.55 | 0.74 |
(22.04 × 1 + 10.2 × 1 + 5.55 × 0.74) × $33.4009 = $1214.02
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.
33755 billing questions
How is this distinguished from a subclavian-to-pulmonary shunt?
Use this code when the shunt originates from the ascending aorta. A shunt originating from the subclavian artery is represented by 33750.
How is this distinguished from a descending aorta shunt?
The aortic origin determines the choice: this code is for the ascending aorta, while 33762 is for the descending aorta.
Does modifier 50 apply?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Are related postoperative visits included?
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?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
4,05033746,,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
4,05633766,,Shunt supr v/c p-art 1 lung,A,,22.98,8.88,NA,8.88,,5.78,37.64,37.64,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,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.,,,,,,