No office rate
33990 is for arterial access only. Choose 33991 when both arterial and venous access are used for the left-heart device insertion.
On this page
CMS RVU26D · Effective 2026-10-01
33990 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$310.02
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Cardiac surgery
About 33990: Percutaneous left ventricular assist device insertion
Reports percutaneous placement of a temporary left-heart assist device through arterial access, such as for cardiogenic shock or support during high-risk PCI.
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.
CMS billing rules for 33990
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.58 · 70%
- Practice expense (office) RVU1.26 · 13%
- Malpractice RVU1.53 · 16%
7.9K
Medicare services in 2024 · #1597 by national volume
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.
33990 compared with similar codes
Office rates for Austin, from the same CMS release.
No office rate
33995 describes percutaneous right-heart assist-device insertion through venous access; 33990 is for left-heart support through arterial access.
No office rate
33992 describes removal of a percutaneous left-heart assist device, not its insertion.
No office rate
33988 describes insertion of a left-heart vent by a surgical approach; 33990 is percutaneous assist-device insertion through arterial access.
The same code, a different location
How does Austin compare?
33990 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 33990
Office
Unavailable
Facility
$305.86
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 33990
Office
Unavailable
Facility
$312.51
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 33990
Office
Unavailable
Facility
$338.10
No comparable office rate is available.
Miami
Florida · 33990
Office
Unavailable
Facility
$392.83
No comparable office rate is available.
Chicago
Illinois · 33990
Office
Unavailable
Facility
$380.89
No comparable office rate is available.
Manhattan
New York · 33990
Office
Unavailable
Facility
$363.80
No comparable office rate is available.
Alaska*
Alaska · 33990
Office
Unavailable
Facility
$402.65
No comparable office rate is available.
Alabama
Alabama · 33990
Office
Unavailable
Facility
$285.53
No comparable office rate is available.
Arkansas
Arkansas · 33990
Office
Unavailable
Facility
$282.25
No comparable office rate is available.
Arizona
Arizona · 33990
Office
Unavailable
Facility
$304.30
No comparable office rate is available.
Bakersfield
California · 33990
Office
Unavailable
Facility
$301.20
No comparable office rate is available.
Chico
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
El Centro
California · 33990
Office
Unavailable
Facility
$297.29
No comparable office rate is available.
Fresno
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Hanford-Corcoran
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Madera
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Merced
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Modesto
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Napa
California · 33990
Office
Unavailable
Facility
$315.05
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 33990
Office
Unavailable
Facility
$307.51
No comparable office rate is available.
Redding
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Rest Of California
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 33990
Office
Unavailable
Facility
$313.45
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 33990
Office
Unavailable
Facility
$304.03
No comparable office rate is available.
Salinas
California · 33990
Office
Unavailable
Facility
$302.76
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 33990
Office
Unavailable
Facility
$304.40
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 33990
Office
Unavailable
Facility
$323.45
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 33990
Office
Unavailable
Facility
$321.72
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 33990
Office
Unavailable
Facility
$332.03
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 33990
Office
Unavailable
Facility
$324.93
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 33990
Office
Unavailable
Facility
$298.84
No comparable office rate is available.
Santa Cruz-Watsonville
California · 33990
Office
Unavailable
Facility
$302.92
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 33990
Office
Unavailable
Facility
$302.39
No comparable office rate is available.
Santa Rosa-Petaluma
California · 33990
Office
Unavailable
Facility
$305.44
No comparable office rate is available.
Stockton
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Vallejo
California · 33990
Office
Unavailable
Facility
$312.55
No comparable office rate is available.
Visalia
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Yuba City
California · 33990
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Colorado
Colorado · 33990
Office
Unavailable
Facility
$307.11
No comparable office rate is available.
Connecticut
Connecticut · 33990
Office
Unavailable
Facility
$331.33
No comparable office rate is available.
Delaware
Delaware · 33990
Office
Unavailable
Facility
$308.40
No comparable office rate is available.
Fort Lauderdale
Florida · 33990
Office
Unavailable
Facility
$354.81
No comparable office rate is available.
Rest Of Florida
Florida · 33990
Office
Unavailable
Facility
$336.82
No comparable office rate is available.
Atlanta
Georgia · 33990
Office
Unavailable
Facility
$324.57
No comparable office rate is available.
Rest Of Georgia
Georgia · 33990
Office
Unavailable
Facility
$318.23
No comparable office rate is available.
Hawaii, Guam
Hawaii · 33990
Office
Unavailable
Facility
$297.22
No comparable office rate is available.
Iowa
Iowa · 33990
Office
Unavailable
Facility
$278.57
No comparable office rate is available.
Idaho
Idaho · 33990
Office
Unavailable
Facility
$282.67
No comparable office rate is available.
East St. Louis
Illinois · 33990
Office
Unavailable
Facility
$361.42
No comparable office rate is available.
Rest Of Illinois
Illinois · 33990
Office
Unavailable
Facility
$338.08
No comparable office rate is available.
Suburban Chicago
Illinois · 33990
Office
Unavailable
Facility
$355.09
No comparable office rate is available.
Indiana
Indiana · 33990
Office
Unavailable
Facility
$283.63
No comparable office rate is available.
Kansas
Kansas · 33990
Office
Unavailable
Facility
$283.58
No comparable office rate is available.
Kentucky
Kentucky · 33990
Office
Unavailable
Facility
$303.95
No comparable office rate is available.
New Orleans
Louisiana · 33990
Office
Unavailable
Facility
$317.43
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 33990
Office
Unavailable
Facility
$305.98
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 33990
Office
Unavailable
Facility
$324.52
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 33990
Office
Unavailable
Facility
$308.34
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 33990
Office
Unavailable
Facility
$331.67
No comparable office rate is available.
Rest Of Maryland
Maryland · 33990
Office
Unavailable
Facility
$311.48
No comparable office rate is available.
Rest Of Maine
Maine · 33990
Office
Unavailable
Facility
$290.28
No comparable office rate is available.
Southern Maine
Maine · 33990
Office
Unavailable
Facility
$293.73
No comparable office rate is available.
Detroit
Michigan · 33990
Office
Unavailable
Facility
$346.55
No comparable office rate is available.
Rest Of Michigan
Michigan · 33990
Office
Unavailable
Facility
$315.90
No comparable office rate is available.
Minnesota
Minnesota · 33990
Office
Unavailable
Facility
$278.21
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 33990
Office
Unavailable
Facility
$309.22
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 33990
Office
Unavailable
Facility
$311.05
No comparable office rate is available.
Rest Of Missouri
Missouri · 33990
Office
Unavailable
Facility
$305.83
No comparable office rate is available.
Mississippi
Mississippi · 33990
Office
Unavailable
Facility
$293.78
No comparable office rate is available.
Montana**
Montana · 33990
Office
Unavailable
Facility
$312.86
No comparable office rate is available.
North Carolina
North Carolina · 33990
Office
Unavailable
Facility
$291.70
No comparable office rate is available.
North Dakota**
North Dakota · 33990
Office
Unavailable
Facility
$282.61
No comparable office rate is available.
Nebraska
Nebraska · 33990
Office
Unavailable
Facility
$277.94
No comparable office rate is available.
New Hampshire
New Hampshire · 33990
Office
Unavailable
Facility
$308.30
No comparable office rate is available.
Northern Nj
New Jersey · 33990
Office
Unavailable
Facility
$337.02
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 33990
Office
Unavailable
Facility
$330.59
No comparable office rate is available.
New Mexico
New Mexico · 33990
Office
Unavailable
Facility
$319.75
No comparable office rate is available.
Nevada**
Nevada · 33990
Office
Unavailable
Facility
$304.47
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 33990
Office
Unavailable
Facility
$378.78
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 33990
Office
Unavailable
Facility
$337.59
No comparable office rate is available.
Queens
New York · 33990
Office
Unavailable
Facility
$357.28
No comparable office rate is available.
Rest Of New York
New York · 33990
Office
Unavailable
Facility
$295.68
No comparable office rate is available.
Ohio
Ohio · 33990
Office
Unavailable
Facility
$309.71
No comparable office rate is available.
Oklahoma
Oklahoma · 33990
Office
Unavailable
Facility
$297.07
No comparable office rate is available.
Portland
Oregon · 33990
Office
Unavailable
Facility
$308.07
No comparable office rate is available.
Rest Of Oregon
Oregon · 33990
Office
Unavailable
Facility
$297.62
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 33990
Office
Unavailable
Facility
$328.51
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 33990
Office
Unavailable
Facility
$306.70
No comparable office rate is available.
Puerto Rico
Puerto Rico · 33990
Office
Unavailable
Facility
$312.66
No comparable office rate is available.
Rhode Island
Rhode Island · 33990
Office
Unavailable
Facility
$313.01
No comparable office rate is available.
South Carolina
South Carolina · 33990
Office
Unavailable
Facility
$302.10
No comparable office rate is available.
South Dakota**
South Dakota · 33990
Office
Unavailable
Facility
$279.03
No comparable office rate is available.
Tennessee
Tennessee · 33990
Office
Unavailable
Facility
$285.48
No comparable office rate is available.
Utah
Utah · 33990
Office
Unavailable
Facility
$305.23
No comparable office rate is available.
Virginia
Virginia · 33990
Office
Unavailable
Facility
$297.23
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 33990
Office
Unavailable
Facility
$312.66
No comparable office rate is available.
Vermont
Vermont · 33990
Office
Unavailable
Facility
$287.30
No comparable office rate is available.
Rest Of Washington
Washington · 33990
Office
Unavailable
Facility
$305.84
No comparable office rate is available.
Seattle (King Cnty)
Washington · 33990
Office
Unavailable
Facility
$324.16
No comparable office rate is available.
Wisconsin
Wisconsin · 33990
Office
Unavailable
Facility
$275.84
No comparable office rate is available.
West Virginia
West Virginia · 33990
Office
Unavailable
Facility
$329.48
No comparable office rate is available.
Wyoming**
Wyoming · 33990
Office
Unavailable
Facility
$299.68
No comparable office rate is available.
See how rates vary across the country
33990 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 33990 in Austin
Multiple payment areas
- 33990 in Barton Creek
- 33990 in Bee Cave
- 33990 in Briarcliff
- 33990 in Cedar Park
Multiple payment areas
- 33990 in Creedmoor
Multiple payment areas
- 33990 in Elgin
Multiple payment areas
- 33990 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 33990 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$341.02
$310.02 × 110% = $341.02
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33990 in Austin.
PPRRVU2026_Oct_nonQPP.csv
4,174
- Code
- 33990
- Physician work
- 6.58
- Practice expense
- 1.26
- Malpractice
- 1.53
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.58 | × 1.002 | 6.5932 |
| Practice expense | 1.26 | × 1.058 | 1.3331 |
| Malpractice | 1.53 | × 0.886 | 1.3556 |
| Total RVUs | 9.2818 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$310.02
Open 33990 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.58 | 1.002 |
| Practice expense | 1.26 | 1.058 |
| Malpractice | 1.53 | 0.886 |
(6.58 × 1.002 + 1.26 × 1.058 + 1.53 × 0.886) × $33.4009 = $310.02
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
33990 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $310.02 | RVU26D |
| 2026-07-01 | Not available in this setting | $310.02 | RVU26C |
| 2026-04-01 | Not available in this setting | $310.02 | RVU26B |
| 2026-01-01 | Not available in this setting | $310.02 | RVU26A |
| 2025-10-01 | Not available in this setting | $340.72 | RVU25D |
| 2025-07-01 | Not available in this setting | $340.72 | RVU25C |
| 2025-04-01 | Not available in this setting | $340.72 | RVU25B |
| 2025-01-01 | Not available in this setting | $340.72 | RVU25A |
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,17133987,,Artery expos/graft artery,A,,3.94,0.81,NA,0.81,,0.95,5.70,5.70,0,ZZZ,0.00,0.00,0.00,0,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17233988,,Insertion of left heart vent,A,,14.63,3.16,NA,3.16,,3.49,21.28,21.28,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17333989,,Removal of left heart vent,A,,9.26,2.05,NA,2.05,,2.21,13.52,13.52,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17433990,,Insj perq vad l hrt arterial,A,,6.58,1.26,NA,1.26,,1.53,9.37,9.37,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17533991,,Insj perq vad l hrt artl&ven,A,,8.62,1.77,NA,1.77,,2.06,12.45,12.45,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17633992,,Rmvl perq left heart vad,A,,3.46,0.66,NA,0.66,,0.82,4.94,4.94,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17733993,,Reposg perq r/l hrt vad,A,,3.02,0.66,NA,0.66,,0.58,4.26,4.26,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858