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Billing code 33974: Balloon removalMedicare rate & RVUs

Removal of an intra-aortic balloon used for temporary circulatory support, reported when the balloon is taken out after the support period ends.

CMS RVU26DEffective Oct 1, 2026109 payment localities17 Medicare services in 2024

Medicare pays $871.76 for 33974 nationally in a facility.

Medicare rate · 33974

Balloon removal

Swap in your local Medicare rate.

Work RVUs
14.65
Total RVUs
26.10
Global days
090

National rate · 2026

$871.76

Facility setting, before claim adjustments.

See every locality for 33974 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 33974 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 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

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

109 of 109 payment localities

33974 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$787.84
Alaska*Unavailable$1,081.20
ArizonaUnavailable$846.70
ArkansasUnavailable$777.62
AtlantaUnavailable$900.98
AustinUnavailable$874.82
BakersfieldUnavailable$860.84
Baltimore/Surr. CntysUnavailable$926.68
BeaumontUnavailable$839.57
BrazoriaUnavailable$847.57

33974 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
33974 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 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

Swap in your local Medicare rate.

Work 14.65Practice expense 7.95Malpractice 3.50

26.1000 adjusted RVUs×$33.4009 conversion factor=$871.76

All indexes start 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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33974

Balloon removal

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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

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%).

When to use modifier 51

33974 compared with similar codes

Compare codes

33974 vs 33968 vs 33973 vs 33977: national Medicare rates

Swap in your local Medicare rate.

  • 33974
    Balloon removal · 14.65 wRVU
    —
  • 33968
    Balloon removal · 0.62 wRVU
    —
  • 33973
    Balloon device · 9.51 wRVU
    —
  • 33977
    VAD removal · 20.34 wRVU
    —

How to choose

33968Balloon removal
Both involve removal of aortic circulatory-support equipment. Use the code whose full billing code descriptor matches the specific device and service documented.
33973Balloon device
This code concerns balloon-device insertion; 33974 is for removal of an intra-aortic balloon.
33977VAD removal
This code is for removal of a ventricular assist device. Use 33974 when the device removed is an intra-aortic balloon.

Codes related to 33974

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

Codes related to 33974
CodeHow it relatesNational office range
Same family
33968Balloon removalRelated aortic assist-device removal code; verify the device and full descriptor before selecting.No office rate
33973Balloon deviceBalloon-device insertion code, useful for distinguishing placement from removal.No office rate
Used instead
33977VAD removalRemoval of a ventricular assist device rather than an intra-aortic balloon.No office rate

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 billing code 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

Show the CMS file lines behind this rate
RVUs for 33974PPRRVU2026_Oct_nonQPP.csv, line 4,158 (RVU26D)

Open CMS sourceHow we calculate rates

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