CPT code 33974: Balloon removal, intra-aortic balloon2026 Medicare rate & RVUs in Missouri
Removal of an intra-aortic balloon used for temporary circulatory support, reported when the balloon is taken out after the support period ends.
CMS doesn’t publish an office rate for 33974 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 33974 covers
This service covers removal of an intra-aortic balloon used for temporary mechanical circulatory support, commonly after a patient’s hemodynamic status improves or the care team changes the support plan. It is generally performed in a hospital by a cardiovascular surgeon or another physician qualified to manage the balloon and its access site. The clinical record should make clear that the device removed was an intra-aortic balloon, rather than a ventricular assist device or another aortic support device.
Report the service for the removal itself, supported by the procedure note identifying the device, the removal performed, and the clinical circumstances. CMS assigns a 90-day major-surgery global period, which includes the day-before preoperative visit and 90 days of related postoperative care. If 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. CMS does not pay an assistant at surgery for this code, and 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 33974 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $852.88 |
| Metropolitan St. Louis, MO | Unavailable | $859.25 |
| Rest of Missouri | Unavailable | $832.08 |
How the 33974 rate is calculated
Each of 33974’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 · 33974
RVUs × geographic indexes × conversion factor
Work14.65
14.65 RVUs× 1.000 GPCI
Practice expense7.95
7.95 RVUs× 1.000 GPCI
Malpractice3.50
3.50 RVUs× 1.000 GPCI
Adjusted RVUs
26.1000
Conversion factor
$33.4009
Medicare rate
$871.76
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33974
33974 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33974
Balloon removal, intra-aortic balloon
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 33974
Balloon removal, intra-aortic balloon
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
33974 without 51 · national facility
$871.76
Balloon removal, intra-aortic balloon
33974-51 · Second procedure: 50%
$435.88
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%).
33974 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33968Balloon removalPercutaneous approach
- Both involve removal of aortic circulatory-support equipment. Use the code whose full CPT descriptor matches the specific device and service documented.
- 33973Balloon deviceInsertion
- This code concerns balloon-device insertion; 33974 is for removal of an intra-aortic balloon.
- 33977VAD removalExtracorporeal, single ventricle
- This code is for removal of a ventricular assist device. Use 33974 when the device removed is an intra-aortic balloon.
33974 billing questions
How is this code different from 33968?
Both codes concern aortic circulatory-support device removal, but their descriptors distinguish the services. Confirm the device and removal circumstances in the operative note and select the code whose full CPT descriptor matches.
Can balloon insertion and removal be reported together?
Insertion and removal are different services and may occur at different points in care. Report removal only when the balloon is actually taken out; the insertion code does not describe that work.
Does the 90-day global period include postoperative care?
Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in this code’s major-surgery global period.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this service. CMS does not pay an assistant at surgery for this code.
What documentation supports reporting this service?
The procedure note should identify the intra-aortic balloon, document that it was removed, and describe the clinical circumstances surrounding removal.
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
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