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Billing code 33989: Heart vent removalMedicare rate & RVUs

Report removal of a left heart vent used to decompress the heart during cardiac surgery, typically when the vent is withdrawn after its use.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $451.58 for 33989 nationally in a facility.

Medicare rate · 33989

Heart vent removal

Swap in your local Medicare rate.

Work RVUs
9.26
Total RVUs
13.52
Global days
000

National rate · 2026

$451.58

Facility setting, before claim adjustments.

See every locality for 33989 → · 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 33989 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 33989 covers

A left heart vent is a temporary tube or cannula used during cardiac surgery to decompress the left side of the heart. A cardiac surgeon typically removes it in the operating room after it is no longer needed, often as the operation and support period are concluding. This service concerns removal of the vent, not removal of a ventricular assist device or other circulatory support device.

Report the removal when documentation identifies the left heart vent and its removal. Code 33988 describes insertion of the vent; the operative record should support the distinct service performed. CMS assigns 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 requires documented medical necessity; co-surgeon and team-surgery payment require supporting documentation.

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 33989 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

33989 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$410.99
Alaska*Unavailable$577.53
ArizonaUnavailable$438.83
ArkansasUnavailable$406.12
AtlantaUnavailable$468.44
AustinUnavailable$447.76
BakersfieldUnavailable$435.17
Baltimore/Surr. CntysUnavailable$479.02
BeaumontUnavailable$440.18
BrazoriaUnavailable$437.20

33989 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
33989 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 33989 rate is calculated

Each of 33989’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 · 33989

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.26Practice expense 2.05Malpractice 2.21

13.5200 adjusted RVUs×$33.4009 conversion factor=$451.58

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

Payment rules and modifiers for 33989

The CMS indicators that decide how 33989 is paid alongside other services.

CMS payment indicators · 33989

Heart vent removal

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)0Not paid without supporting documentation.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33989 without 51 · national facility

$451.58

Heart vent removal

33989-51 · Second procedure: 50%

$225.79

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

33989 compared with similar codes

Compare codes

33989 vs 33988 vs 33992 vs 33977: national Medicare rates

Swap in your local Medicare rate.

  • 33989
    Heart vent removal · 9.26 wRVU
    —
  • 33988
    Left heart vent · 14.63 wRVU
    —
  • 33992
    VAD removal · 3.46 wRVU
    —
  • 33977
    VAD removal · 20.34 wRVU
    —

How to choose

33988Left heart vent
33988 reports insertion of a left heart vent; 33989 reports its removal. Use the operative documentation to identify the service performed.
33992VAD removal
33992 describes removal of a percutaneous left heart ventricular assist device. Code 33989 is for removal of a left heart vent.
33977VAD removal
33977 describes removal of a ventricular assist device, not removal of a temporary left heart vent.

Codes related to 33989

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

Codes related to 33989
CodeHow it relatesNational office range
Often billed with
33988Left heart ventInsertion of the left heart vent that may later be removed during the operative encounter.No office rate
Used instead
33992VAD removalRemoval code for a percutaneous left heart ventricular assist device, not a vent.No office rate
33977VAD removalRemoval of a ventricular assist device rather than a left heart vent.No office rate
33978VAD removalAnother ventricular assist device removal code; distinguish the device from a temporary vent.No office rate

33989 billing questions

How is removal of a left heart vent different from 33988?

Code 33989 is for removing the vent; 33988 is for inserting it. The operative report should make clear which service was performed.

Is this code for removing a ventricular assist device?

No. It describes removal of a left heart vent, not a ventricular assist device. Codes such as 33992 and 33977 describe removal of different support devices.

What documentation supports reporting 33989?

Document that a left heart vent was present and removed, along with the operative circumstances. The record should distinguish the vent from a ventricular assist device.

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

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

How are multiple procedures in the same session paid?

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

What documentation is needed for assistant or team surgery payment?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment require supporting documentation.

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 33989PPRRVU2026_Oct_nonQPP.csv, line 4,173 (RVU26D)

Open CMS sourceHow we calculate rates

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