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CPT code 33992: VAD removal, percutaneous left-heart device2026 Medicare rate & RVUs

Removal of a percutaneously placed left-heart ventricular assist device is reported when temporary mechanical circulatory support is discontinued.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.7K Medicare services in 2024

Medicare pays $165.00 for 33992 nationally in a facility.

Medicare rate · 33992

VAD removal, percutaneous left-heart device

Office or facility?

Work RVUs
3.46
Total RVUs
4.94
Global days
000

National rate · 2026

$165.00

Facility setting, before claim adjustments.

See every locality for 33992 →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 33992 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 33992 covers

This service covers withdrawing a catheter-based ventricular assist device used to support the left heart. It is commonly performed by an interventional cardiologist or cardiac surgeon in a catheterization laboratory or other procedural setting when the patient’s hemodynamic condition allows temporary support to end. The code identifies removal of the percutaneous left-heart device, rather than implantation, repositioning, or removal of a right-heart device.

Report the code when the documented service removes that percutaneous left-heart VAD; the record should identify the device and support the removal performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this descriptor. Assistant-at-surgery services may be paid; 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 33992 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

33992 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$150.36
AlaskaUnavailable$211.92
ArizonaUnavailable$160.37
ArkansasUnavailable$148.61
Atlanta, GAUnavailable$171.20
Austin, TXUnavailable$163.39
Bakersfield, CAUnavailable$158.60
Baltimore area, MDUnavailable$174.95
Beaumont, TXUnavailable$161.07
Brazoria, TXUnavailable$159.70

33992 rates by state

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

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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
33992 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 33992 rate is calculated

Each of 33992’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 · 33992

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.46

3.46 RVUs× 1.000 GPCI

Practice expense0.66

0.66 RVUs× 1.000 GPCI

Malpractice0.82

0.82 RVUs× 1.000 GPCI

Adjusted RVUs

4.9400

Conversion factor

$33.4009

Medicare rate

$165.00

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

Payment rules and modifiers for 33992

The CMS indicators that decide how 33992 is paid alongside other services.

CMS payment indicators · 33992

VAD removal, percutaneous left-heart device

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

33992 without 51 · national facility

$165.00

VAD removal, percutaneous left-heart device

33992-51 · Second procedure: 50%

$82.50

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

33992 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 33992

    VAD removal, percutaneous left-heart device3.46 wRVU

    Not priced

  • 33990

    VAD insertion, left heart, arterial access6.58 wRVU

    Not priced

  • 33991

    VAD insertion, left heart, arterial and venous access8.62 wRVU

    Not priced

  • 33997

    VAD removal, percutaneous, right heart2.93 wRVU

    Not priced

  • 33989

    Heart vent removal, left heart vent9.26 wRVU

    Not priced

How to choose

33990VAD insertionLeft heart, arterial access
33990 describes insertion of a percutaneous left-heart VAD through arterial access; 33992 describes its removal.
33991VAD insertionLeft heart, arterial and venous access
33991 describes percutaneous left-heart VAD insertion using arterial and venous access. It is not the removal service represented by 33992.
33997VAD removalPercutaneous, right heart
33997 is for removal of a percutaneous right-heart VAD; 33992 is for a percutaneous left-heart VAD.
33989Heart vent removalLeft heart vent
33989 describes removal of a left-heart vent. Select 33992 when the removed device is a percutaneous left-heart VAD.

Codes related to 33992

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

Codes related to 33992
CodeHow it relatesNational office range
Same family
33990VAD insertion, left heart, arterial accessPercutaneous left-heart VAD insertion using an arterial access approach.No office rate
33991VAD insertion, left heart, arterial and venous accessPercutaneous left-heart VAD insertion using arterial and venous access.No office rate
33993VAD repositioning, percutaneous right or left heartRepositioning service for a percutaneous right- or left-heart VAD.No office rate
Used instead
33997VAD removal, percutaneous, right heartRemoval code when the percutaneous VAD supports the right heart.No office rate
33989Heart vent removal, left heart ventRemoval of a left-heart vent rather than a percutaneous left-heart VAD.No office rate

33992 billing questions

How is removal distinguished from repositioning?

Report 33992 when the percutaneous left-heart VAD is removed. Code 33993 describes repositioning a percutaneous right- or left-heart VAD, not removal.

Is 33992 used for VAD insertion?

No. Codes 33990 and 33991 describe percutaneous left-heart VAD insertion, with different access configurations; 33992 describes removal.

When does 33997 apply instead?

Use 33997 for removal of a percutaneous right-heart VAD. Code 33992 is specific to a percutaneous left-heart VAD.

Can modifier 50 be used for this removal?

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, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.

What documentation supports reporting 33992?

Document that the device was a percutaneous left-heart VAD and that it was removed. The record should distinguish removal from repositioning or removal of a right-heart device.

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 33992PPRRVU2026_Oct_nonQPP.csv, line 4,176 (RVU26D)

Open CMS sourceHow we calculate rates

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