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CPT code 33967: Balloon pump insertion, percutaneous approach2026 Medicare rate & RVUs

Reports percutaneous placement of an intra-aortic balloon pump for temporary circulatory support, such as in cardiogenic shock or selected high-risk cardiac procedures.

CMS RVU26DEffective Oct 1, 2026109 payment localities9.9K Medicare services in 2024

Medicare pays $224.79 for 33967 nationally in a facility.

Medicare rate · 33967

Balloon pump insertion, percutaneous approach

Office or facility?

Work RVUs
4.72
Total RVUs
6.73
Global days
000

National rate · 2026

$224.79

Facility setting, before claim adjustments.

See every locality for 33967 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 33967 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 33967 covers

This service places an intra-aortic balloon catheter through percutaneous arterial access, commonly in a hospital catheterization laboratory or operating room. The balloon sits in the aorta and provides counterpulsation to support circulation. Cardiologists and cardiothoracic surgeons commonly perform the insertion for patients needing temporary hemodynamic support, including some patients with cardiogenic shock or undergoing high-risk cardiac procedures.

Report 33967 for the percutaneous insertion itself, not for removal or insertion by a nonpercutaneous approach. The procedure note should establish the indication, access technique, and device placement. The 0-day global period includes same-day preoperative and postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are 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 33967 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

33967 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$205.15
AlaskaUnavailable$289.26
ArizonaUnavailable$218.59
ArkansasUnavailable$202.80
Atlanta, GAUnavailable$233.07
Austin, TXUnavailable$222.74
Bakersfield, CAUnavailable$216.50
Baltimore area, MDUnavailable$238.18
Beaumont, TXUnavailable$219.44
Brazoria, TXUnavailable$217.76

33967 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
33967 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 33967 rate is calculated

Each of 33967’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 · 33967

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.72

4.72 RVUs× 1.000 GPCI

Practice expense0.92

0.92 RVUs× 1.000 GPCI

Malpractice1.09

1.09 RVUs× 1.000 GPCI

Adjusted RVUs

6.7300

Conversion factor

$33.4009

Medicare rate

$224.79

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 33967

The CMS indicators that decide how 33967 is paid alongside other services.

CMS payment indicators · 33967

Balloon pump insertion, percutaneous approach

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33967 without 51 · national facility

$224.79

Balloon pump insertion, percutaneous approach

33967-51 · Second procedure: 50%

$112.40

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%).

When to use modifier 51

33967 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 33967

    Balloon pump insertion, percutaneous approach4.72 wRVU

    Not priced

  • 33968

    Balloon removal, percutaneous approach0.62 wRVU

    Not priced

  • 33970

    Aortic assist device, open transthoracic insertion6.57 wRVU

    Not priced

  • 33990

    VAD insertion, left heart, arterial access6.58 wRVU

    Not priced

How to choose

33968Balloon removalPercutaneous approach
33967 reports percutaneous insertion; 33968 reports percutaneous removal of the intra-aortic balloon pump.
33970Aortic assist deviceOpen transthoracic insertion
Both describe intra-aortic balloon pump insertion, but 33970 is for a nonpercutaneous approach.
33990VAD insertionLeft heart, arterial access
33990 describes percutaneous insertion of a ventricular assist device, not placement of an intra-aortic balloon pump.

Codes related to 33967

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 33967
CodeHow it relatesNational office range
Used instead
33970Aortic assist device, open transthoracic insertionInsertion of an intra-aortic balloon pump by a nonpercutaneous approach.No office rate
33990VAD insertion, left heart, arterial accessPercutaneous ventricular assist device insertion with arterial access only.No office rate
33991VAD insertion, left heart, arterial and venous accessPercutaneous ventricular assist device insertion using arterial and venous access.No office rate

33967 billing questions

How does 33967 differ from 33970?

33967 is for percutaneous balloon-pump insertion. Use 33970 for insertion by a nonpercutaneous approach.

Is removal included in 33967?

No. Code 33967 reports insertion; 33968 is the percutaneous removal code.

Does the 0-day global period include same-day care?

Yes. Same-day preoperative and postoperative care is included in the global period.

Can modifier 50 be reported?

No. Bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

When is assistant-at-surgery payment allowed?

It is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.

How does 33967 differ from percutaneous ventricular assist device insertion?

33967 is for an intra-aortic balloon pump. Codes such as 33990 and 33991 describe percutaneous ventricular assist device insertion, a different form of circulatory support.

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
RVUs for 33967PPRRVU2026_Oct_nonQPP.csv, line 4,152 (RVU26D)

Open CMS sourceHow we calculate rates

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