CPT code 33988: Left heart vent, insertion2026 Medicare rate & RVUs in Montana
Reports surgical placement of a left heart vent to decompress the left-sided chambers during cardiac surgery, typically while the patient is on cardiopulmonary bypass.
In Montana, Medicare pays $710.54 for 33988 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33988 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 33988 covers
A left heart vent temporarily drains blood from the left side of the heart to help prevent chamber distention during cardiac surgery. A cardiothoracic surgeon typically places it in the operating room as part of an open cardiac procedure, often while the patient is supported by cardiopulmonary bypass. The operative report should identify the placement and the vent’s role in the procedure.
Report 33988 for the insertion service, not for removal of the vent; distinguish the work from the principal cardiac operation in the documentation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery, co-surgeon, and team-surgery payment each require supporting documentation; assistant payment specifically requires medical necessity.
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.
How Montana compares for 33988
Across 109 of 109 payment localities, the facility rate for 33988 runs from $625.67 in Wisconsin to $909.62 in Alaska. Montana pays $710.54. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$710.54
- Los Angeles, CA · California$710.95+$0.41
- Washington, DC area · District of Columbia$769.12+$58.58
- Miami, FL · Florida$893.33+$182.79
- Chicago, IL · Illinois$865.68+$155.14
- Manhattan, NY · New York$827.45+$116.91
- Alaska · Alaska$909.62+$199.08
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $646.99 |
| ArkansasArkansas | — | $639.35 |
| ArizonaArizona | — | $690.71 |
| Bakersfield, CACalifornia | — | $684.61 |
| Chico, CACalifornia | — | $675.12 |
| El Centro, CACalifornia | — | $675.71 |
| Fresno, CACalifornia | — | $675.12 |
| Hanford, CACalifornia | — | $675.12 |
| Madera, CACalifornia | — | $675.12 |
| Merced, CACalifornia | — | $675.12 |
| Modesto, CACalifornia | — | $675.12 |
| Napa, CACalifornia | — | $717.77 |
| Oxnard, CACalifornia | — | $699.72 |
| Redding, CACalifornia | — | $675.12 |
| Rest of CaliforniaCalifornia | — | $675.12 |
| Riverside, CACalifornia | — | $712.56 |
| Sacramento, CACalifornia | — | $691.48 |
| Salinas, CACalifornia | — | $688.61 |
| San Diego, CACalifornia | — | $692.73 |
| Marin County, CACalifornia | — | $737.40 |
| San Francisco, CACalifornia | — | $733.44 |
| San Benito County, CACalifornia | — | $757.09 |
| Santa Clara County, CACalifornia | — | $740.88 |
| San Luis Obispo, CACalifornia | — | $679.66 |
| Santa Cruz, CACalifornia | — | $689.64 |
| Santa Maria, CACalifornia | — | $687.89 |
| Santa Rosa, CACalifornia | — | $695.41 |
| Stockton, CACalifornia | — | $675.12 |
| Vallejo, CACalifornia | — | $712.06 |
| Visalia, CACalifornia | — | $675.12 |
| Yuba City, CACalifornia | — | $675.12 |
| ColoradoColorado | — | $697.86 |
| ConnecticutConnecticut | — | $753.15 |
| DelawareDelaware | — | $700.17 |
| Fort Lauderdale, FLFlorida | — | $806.33 |
| Rest of FloridaFlorida | — | $764.76 |
| Atlanta, GAGeorgia | — | $737.36 |
| Rest of GeorgiaGeorgia | — | $721.75 |
| Hawaii, Guam, HIHawaii | — | $676.16 |
| IowaIowa | — | $631.51 |
| IdahoIdaho | — | $640.90 |
| East St. Louis, ILIllinois | — | $820.53 |
| Rest of IllinoisIllinois | — | $767.22 |
| Suburban Chicago, ILIllinois | — | $807.03 |
| IndianaIndiana | — | $643.15 |
| KansasKansas | — | $642.82 |
| KentuckyKentucky | — | $689.15 |
| New Orleans, LALouisiana | — | $720.40 |
| Rest of LouisianaLouisiana | — | $693.74 |
| Metropolitan Boston, MAMassachusetts | — | $738.46 |
| Rest of MassachusettsMassachusetts | — | $700.52 |
| Baltimore area, MDMaryland | — | $753.92 |
| Rest of MarylandMaryland | — | $707.37 |
| Rest of MaineMaine | — | $658.26 |
| Southern Maine, MEMaine | — | $666.81 |
| Detroit, MIMichigan | — | $787.04 |
| Rest of MichiganMichigan | — | $716.63 |
| MinnesotaMinnesota | — | $631.77 |
| Metropolitan Kansas City, MOMissouri | — | $701.65 |
| Metropolitan St. Louis, MOMissouri | — | $705.94 |
| Rest of MissouriMissouri | — | $693.17 |
| MississippiMississippi | — | $665.68 |
| North CarolinaNorth Carolina | — | $661.62 |
| North DakotaNorth Dakota | — | $641.53 |
| NebraskaNebraska | — | $630.14 |
| New HampshireNew Hampshire | — | $700.53 |
| Northern New JerseyNew Jersey | — | $766.37 |
| Rest of New JerseyNew Jersey | — | $751.33 |
| New MexicoNew Mexico | — | $725.44 |
| NevadaNevada | — | $691.41 |
| NYC suburbs and Long Island, NYNew York | — | $861.89 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $767.27 |
| Queens, NYNew York | — | $812.78 |
| Rest of New YorkNew York | — | $670.87 |
| OhioOhio | — | $702.52 |
| OklahomaOklahoma | — | $673.48 |
| Portland, OROregon | — | $700.46 |
| Rest of OregonOregon | — | $675.73 |
| Metropolitan Philadelphia, PAPennsylvania | — | $746.39 |
| Rest of PennsylvaniaPennsylvania | — | $695.71 |
| Puerto RicoPuerto Rico | — | $710.18 |
| Rhode IslandRhode Island | — | $710.95 |
| South CarolinaSouth Carolina | — | $685.26 |
| South DakotaSouth Dakota | — | $633.37 |
| TennesseeTennessee | — | $647.19 |
| Austin, TXTexas | — | $704.58 |
| Beaumont, TXTexas | — | $693.00 |
| Brazoria, TXTexas | — | $688.09 |
| Dallas, TXTexas | — | $698.19 |
| Fort Worth, TXTexas | — | $698.65 |
| Galveston, TXTexas | — | $693.89 |
| Houston, TXTexas | — | $757.77 |
| Rest of TexasTexas | — | $694.08 |
| UtahUtah | — | $692.55 |
| VirginiaVirginia | — | $674.71 |
| Virgin Islands, VIUnited States Virgin Islands | — | $710.18 |
| VermontVermont | — | $652.13 |
| Rest of WashingtonWashington | — | $694.86 |
| King County, WAWashington | — | $737.83 |
| WisconsinWisconsin | — | $625.67 |
| West VirginiaWest Virginia | — | $747.19 |
| WyomingWyoming | — | $680.46 |
33988 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 33988 rate is calculated
Each of 33988’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 · 33988
RVUs × geographic indexes × conversion factor
Work14.63
14.63 RVUs× 1.000 GPCI
Practice expense3.16
3.16 RVUs× 1.000 GPCI
Malpractice3.49
3.49 RVUs× 1.000 GPCI
Adjusted RVUs
21.2800
Conversion factor
$33.4009
Medicare rate
$710.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,172
- Code
- 33988
- Physician work
- 14.63
- Practice expense
- 3.16
- Malpractice
- 3.49
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.63 | × 1.000 | 14.6300 |
| Practice expense | 3.16 | × 1.000 | 3.1600 |
| Malpractice | 3.49 | × 0.998 | 3.4830 |
| Total RVUs | 21.2730 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Montana$710.54
Facility: (14.63 × 1 + 3.16 × 1 + 3.49 × 0.998) × $33.4009 = $710.54
Payment rules and modifiers for 33988
The CMS indicators that decide how 33988 is paid alongside other services.
CMS payment indicators · 33988
Left heart vent, insertion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33988 without 51 · national facility
$710.77
Left heart vent, insertion
33988-51 · Second procedure: 50%
$355.39
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%).
How 33988 has changed in Montana
33988 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2015
RVU15A
No ratechanged toNo rate
Held through RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $710.54 | RVU26D |
| 2026-07-01 | Not available in this setting | $710.54 | RVU26C |
| 2026-04-01 | Not available in this setting | $710.54 | RVU26B |
| 2026-01-01 | Not available in this setting | $710.54 | RVU26A |
| 2025-10-01 | Not available in this setting | $730.85 | RVU25D |
| 2025-07-01 | Not available in this setting | $730.85 | RVU25C |
| 2025-04-01 | Not available in this setting | $730.85 | RVU25B |
| 2025-01-01 | Not available in this setting | $730.85 | RVU25A |
| 2024-10-01 | Not available in this setting | $749.09 | RVU24D |
| 2024-07-01 | Not available in this setting | $749.09 | RVU24C |
| 2024-04-01 | Not available in this setting | $749.09 | RVU24B |
| 2024-03-09 | Not available in this setting | $749.09 | RVU24AR |
| 2024-01-01 | Not available in this setting | $736.86 | RVU24A |
| 2023-10-01 | Not available in this setting | $763.34 | RVU23D |
| 2023-07-01 | Not available in this setting | $763.34 | RVU23C |
| 2023-04-01 | Not available in this setting | $763.34 | RVU23B |
| 2023-01-01 | Not available in this setting | $763.34 | RVU23A |
| 2022-10-01 | Not available in this setting | $784.49 | RVU22D |
| 2022-07-01 | Not available in this setting | $784.49 | RVU22C |
| 2022-04-01 | Not available in this setting | $784.49 | RVU22B |
| 2022-01-01 | Not available in this setting | $784.49 | RVU22A |
| 2021-10-01 | Not available in this setting | $788.99 | RVU21D |
| 2021-07-01 | Not available in this setting | $788.99 | RVU21C |
| 2021-04-01 | Not available in this setting | $788.99 | RVU21B |
| 2021-01-01 | Not available in this setting | $788.99 | RVU21A |
| 2020-10-01 | Not available in this setting | $851.15 | RVU20D |
| 2020-07-01 | Not available in this setting | $851.15 | RVU20C |
| 2020-04-01 | Not available in this setting | $851.15 | RVU20B |
| 2020-01-01 | Not available in this setting | $851.15 | RVU20A |
| 2019-10-01 | Not available in this setting | $900.03 | RVU19D |
| 2019-07-01 | Not available in this setting | $900.03 | RVU19C |
| 2019-04-01 | Not available in this setting | $887.69 | RVU19B |
| 2019-01-01 | Not available in this setting | $887.69 | RVU19A |
| 2018-10-01 | Not available in this setting | $896.83 | RVU18D |
| 2018-07-01 | Not available in this setting | $896.83 | RVU18C |
| 2018-04-01 | Not available in this setting | $896.83 | RVU18B |
| 2018-01-01 | Not available in this setting | $896.83 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $873.64 | RVU17D |
| 2017-07-01 | Not available in this setting | $873.64 | RVU17C |
| 2017-04-01 | Not available in this setting | $873.64 | RVU17B |
| 2017-01-01 | Not available in this setting | $873.64 | RVU17A |
| 2016-10-01 | Not available in this setting | $839.23 | RVU16D |
| 2016-07-01 | Not available in this setting | $839.23 | RVU16C |
| 2016-04-01 | Not available in this setting | $839.23 | RVU16B |
| 2016-01-01 | Not available in this setting | $839.23 | RVU16A |
| 2015-10-01 | Not available in this setting | $842.66 | RVU15D |
| 2015-07-01 | Not available in this setting | $842.66 | RVU15C |
| 2015-04-01 | Not available in this setting | $838.47 | RVU15B |
| 2015-01-01 | Not available in this setting | $838.47 | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
33988 billing questions
How does insertion differ from removal of a left heart vent?
Use 33988 for placement. Code 33989 describes the removal service.
What documentation supports reporting 33988?
The operative report should establish that the surgeon placed a left heart vent and describe its role in the cardiac procedure.
Is modifier 50 appropriate?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, CMS pays the highest-valued procedure in full and the other procedures at 50%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment require supporting documentation.
Does the code include same-day postoperative care?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
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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