CPT code 33990: VAD insertion, left heart, arterial access2026 Medicare rate & RVUs in New Mexico

Reports percutaneous placement of a temporary left-heart assist device through arterial access, such as for cardiogenic shock or support during high-risk PCI.

CMS RVU26DEffective Oct 1, 2026One payment locality7.9K Medicare services in 2024

In New Mexico, Medicare pays $319.75 for 33990 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$319.75Hospital or facility

Check a contract rate as a % of Medicare · 33990 nationwide

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

We’ll open 33990 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 33990 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 33990 covers

This service places a temporary percutaneous ventricular assist device in the left heart through arterial access, commonly the femoral artery, with the device positioned to support systemic circulation. Interventional cardiologists and cardiac surgeons perform it in a catheterization laboratory or other hospital setting, often for cardiogenic shock or hemodynamic support during high-risk percutaneous coronary intervention. Imaging supervision and interpretation for device placement are part of the service.

Report 33990 when the left-heart device is inserted using arterial access only; documentation should establish the access route, device placement, clinical indication, and imaging used to guide placement. The code has a 0-day global period, so same-day preoperative and postoperative care is included. 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% multiple-procedure reduction. Assistant-at-surgery payment may be made; 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.

How New Mexico compares for 33990

Across 109 of 109 payment localities, the facility rate for 33990 runs from $275.84 in Wisconsin to $402.65 in Alaska. New Mexico pays $319.75. The RVUs are the same everywhere; the geographic indexes change the dollars.

33990 in New Mexico vs other payment areas
  1. New Mexico · this page$319.75
  2. Los Angeles, CA · California$312.51−$7.24
  3. Washington, DC area · District of Columbia$338.10+$18.35
  4. Miami, FL · Florida$392.83+$73.08
  5. Chicago, IL · Illinois$380.89+$61.14
  6. Manhattan, NY · New York$363.80+$44.05
  7. Alaska · Alaska$402.65+$82.90

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

33990 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$285.53
ArkansasArkansas—$282.25
ArizonaArizona—$304.30
Bakersfield, CACalifornia—$301.20
Chico, CACalifornia—$297.03
El Centro, CACalifornia—$297.29
Fresno, CACalifornia—$297.03
Hanford, CACalifornia—$297.03

33990 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
33990 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

See 33990 in every payment locality

How the 33990 rate is calculated

Each of 33990’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 · 33990

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.58

6.58 RVUs× 1.000 GPCI

Practice expense1.26

1.26 RVUs× 1.000 GPCI

Malpractice1.53

1.53 RVUs× 1.000 GPCI

Adjusted RVUs

9.3700

Conversion factor

$33.4009

Medicare rate

$312.97

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

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,174

Code
33990
Physician work
6.58
Practice expense
1.26
Malpractice
1.53

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Facility calculation for 33990 in New Mexico
ComponentRVULocality factorAdjusted
Physician work6.58× 1.0006.5800
Practice expense1.26× 0.9171.1554
Malpractice1.53× 1.2011.8375
Total RVUs9.5730
Conversion factor× 33.4009

Facility rate, New Mexico$319.75

Facility: (6.58 × 1 + 1.26 × 0.917 + 1.53 × 1.201) × $33.4009 = $319.75

Open 33990 in the RVU calculator

Payment rules and modifiers for 33990

The CMS indicators that decide how 33990 is paid alongside other services.

CMS payment indicators · 33990

VAD insertion, left heart, arterial access

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)2Paid.
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

33990 without 51 · national facility

$312.97

VAD insertion, left heart, arterial access

33990-51 · Second procedure: 50%

$156.49

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

How 33990 has changed in New Mexico

33990 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$319.75RVU26D
2026-07-01Not available in this setting$319.75RVU26C
2026-04-01Not available in this setting$319.75RVU26B
2026-01-01Not available in this setting$319.75RVU26A
2025-10-01Not available in this setting$343.31RVU25D
2025-07-01Not available in this setting$343.31RVU25C
2025-04-01Not available in this setting$343.31RVU25B
2025-01-01Not available in this setting$343.31RVU25A
2024-10-01Not available in this setting$353.08RVU24D
2024-07-01Not available in this setting$353.08RVU24C
2024-04-01Not available in this setting$353.08RVU24B
2024-03-09Not available in this setting$353.08RVU24AR
2024-01-01Not available in this setting$347.32RVU24A
2023-10-01Not available in this setting$358.25RVU23D
2023-07-01Not available in this setting$358.25RVU23C
2023-04-01Not available in this setting$358.25RVU23B
2023-01-01Not available in this setting$358.25RVU23A
2022-10-01Not available in this setting$367.36RVU22D
2022-07-01Not available in this setting$367.36RVU22C
2022-04-01Not available in this setting$367.36RVU22B
2022-01-01Not available in this setting$367.36RVU22A
2021-10-01Not available in this setting$368.78RVU21D
2021-07-01Not available in this setting$368.78RVU21C
2021-04-01Not available in this setting$368.78RVU21B
2021-01-01Not available in this setting$368.78RVU21A
2020-10-01Not available in this setting$448.62RVU20D
2020-07-01Not available in this setting$448.62RVU20C
2020-04-01Not available in this setting$448.62RVU20B
2020-01-01Not available in this setting$448.62RVU20A
2019-10-01Not available in this setting$455.34RVU19D
2019-07-01Not available in this setting$455.34RVU19C
2019-04-01Not available in this setting$455.34RVU19B
2019-01-01Not available in this setting$455.34RVU19A
2018-10-01Not available in this setting$454.39RVU18D
2018-07-01Not available in this setting$454.39RVU18C
2018-04-01Not available in this setting$454.39RVU18B
2018-01-01Not available in this setting$454.39RVU18AR1
2017-10-01Not available in this setting$450.88RVU17D
2017-07-01Not available in this setting$450.88RVU17C
2017-04-01Not available in this setting$450.88RVU17B
2017-01-01Not available in this setting$450.88RVU17A
2016-10-01Not available in this setting$462.10RVU16D
2016-07-01Not available in this setting$462.10RVU16C
2016-04-01Not available in this setting$462.10RVU16B
2016-01-01Not available in this setting$462.10RVU16A
2015-10-01Not available in this setting$462.26RVU15D
2015-07-01Not available in this setting$462.26RVU15C
2015-04-01Not available in this setting$459.96RVU15B
2015-01-01Not available in this setting$459.96RVU15A
2014-10-01Not available in this setting$450.63RVU14D
2014-07-01Not available in this setting$450.63RVU14C
2014-04-01Not available in this setting$450.63RVU14B
2014-01-01Not available in this setting$450.63RVU14A
2013-10-01Not available in this setting$431.27RVU13D
2013-07-01Not available in this setting$431.27RVU13C
2013-04-01Not available in this setting$431.27RVU13B
2013-01-01Not available in this setting$431.27RVU13AR

Price 33990 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

33990 billing questions

How does 33990 differ from 33991?

Use 33990 for left-heart device insertion with arterial access only. Use 33991 when insertion requires both arterial and venous access.

Is imaging reported separately?

Imaging supervision and interpretation for device placement are included in this service.

What documentation supports 33990?

Document the indication, arterial access, device placement in the left heart, and imaging used to guide the procedure.

Can an assistant surgeon be reported?

Assistant-at-surgery payment may be made for this code. Co-surgeons and team surgery are not permitted.

How does the 0-day global affect same-day care?

Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

How is 33990 affected when other procedures occur in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 33990PPRRVU2026_Oct_nonQPP.csv, line 4,174 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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