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Billing code 33977: VAD removalMedicare rate & RVUs

Reports operative removal of an extracorporeal ventricular assist device supporting one ventricle, such as when temporary mechanical support is no longer needed.

CMS RVU26DEffective Oct 1, 2026109 payment localities266 Medicare services in 2024

Medicare pays $1,035.43 for 33977 nationally in a facility.

Medicare rate · 33977

VAD removal

Swap in your local Medicare rate.

Work RVUs
20.34
Total RVUs
31.00
Global days
XXX

National rate · 2026

$1,035.43

Facility setting, before claim adjustments.

See every locality for 33977 → · 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 33977 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 33977 covers

This code covers surgery to remove an extracorporeal ventricular assist device that has been supporting a single ventricle. A cardiac or cardiothoracic surgeon typically performs the removal in a hospital operating room after the patient’s need for temporary mechanical circulatory support has ended. The code distinguishes this device and support configuration from an intracorporeal VAD and from extracorporeal support for both ventricles.

Select the code when the operative record identifies an extracorporeal device, support of one ventricle, and its removal. Documentation should establish the device type and the removal performed; the code is not selected by the length of support. Under the CMS multiple-procedure rule, when this service is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

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 33977 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

33977 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$939.83
Alaska*Unavailable$1,313.28
ArizonaUnavailable$1,005.71
ArkansasUnavailable$928.35
AtlantaUnavailable$1,073.75
AustinUnavailable$1,029.00
BakersfieldUnavailable$1,002.00
Baltimore/Surr. CntysUnavailable$1,099.40
BeaumontUnavailable$1,006.52
BrazoriaUnavailable$1,002.77

33977 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
33977 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 33977 rate is calculated

Each of 33977’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 · 33977

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 20.34Practice expense 5.71Malpractice 4.95

31.0000 adjusted RVUs×$33.4009 conversion factor=$1,035.43

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 33977

The CMS indicators that decide how 33977 is paid alongside other services.

CMS payment indicators · 33977

VAD removal

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
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

33977 without 51 · national facility

$1,035.43

VAD removal

33977-51 · Second procedure: 50%

$517.72

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

33977 compared with similar codes

Compare codes

33977 vs 33978 vs 33980 vs 33975: national Medicare rates

Swap in your local Medicare rate.

  • 33977
    VAD removal · 20.34 wRVU
    —
  • 33978
    VAD removal · 24.38 wRVU
    —
  • 33980
    VAD removal · 32.66 wRVU
    —
  • 33975
    Ventricular assist device · 24.38 wRVU
    —

How to choose

33978VAD removal
Choose 33977 for extracorporeal support of one ventricle and 33978 for extracorporeal support of both ventricles.
33980VAD removal
33980 describes removal of an intracorporeal VAD; 33977 is for an extracorporeal device supporting one ventricle.
33975Ventricular assist device
33975 is for placing an extracorporeal VAD to support one ventricle. 33977 describes removal of that type of support.

Codes related to 33977

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

Codes related to 33977
CodeHow it relatesNational office range
Same family
33978VAD removalRemoval counterpart for extracorporeal VAD support of both ventricles.No office rate
33975Ventricular assist devicePlacement code for extracorporeal VAD support of one ventricle.No office rate
Used instead
33980VAD removalRemoval code when the VAD is intracorporeal rather than extracorporeal.No office rate

33977 billing questions

How does 33977 differ from 33978?

33977 is for removal of an extracorporeal VAD supporting one ventricle. 33978 is the corresponding removal code for biventricular support.

When is 33980 more appropriate?

Use 33980 for removal of an intracorporeal VAD. Code 33977 describes an extracorporeal device supporting a single ventricle.

What should the operative note document?

Document that the device was extracorporeal, that it supported one ventricle, and that the service included its operative removal.

Is 33977 selected by operative time?

No. The code is selected by the device configuration and removal performed, not by elapsed time.

How is 33977 paid when other procedures are performed in the same session?

The highest-valued procedure is paid in full; the other procedures are subject to the standard multiple-procedure reduction to 50%.

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 33977PPRRVU2026_Oct_nonQPP.csv, line 4,161 (RVU26D)

Open CMS sourceHow we calculate rates

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