No office rate
Choose 33997 for percutaneous right-heart VAD removal; 33992 is for percutaneous left-heart VAD removal.
On this page
CMS RVU26D · Effective 2026-10-01
33997 in Madera
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$132.76
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.
Cardiovascular surgery
About 33997: Percutaneous right-heart VAD removal
Removal of a percutaneously placed right-heart ventricular assist device, typically after temporary mechanical support for acute right ventricular failure is no longer needed.
This service removes a temporary ventricular assist device that provides percutaneous support to the right side of the heart, generally through venous access. It is typically performed by a cardiac surgeon or interventional cardiologist in a hospital setting, such as a cardiac catheterization laboratory or intensive care unit, when the patient has recovered enough to stop mechanical support or the device must be removed for another clinical reason.
Report the removal rather than device insertion or repositioning, and document the device, its percutaneous right-heart configuration, the removal, and the reason support is ending. The CMS global period is 0 days, 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 multiple procedure reduction. Modifier 50 is inappropriate for this single right-heart device service. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 33997
- 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 RVU2.93 · 70%
- Practice expense (office) RVU0.58 · 14%
- Malpractice RVU0.67 · 16%
127
Medicare services in 2024 · #4687 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.
33997 compared with similar codes
Office rates for Madera, from the same CMS release.
No office rate
33993 represents repositioning a percutaneous right- or left-heart VAD. Report 33997 when the right-heart device is removed.
No office rate
33995 is for placing percutaneous right-heart VAD support; 33997 is for taking that type of device out.
No office rate
33980 concerns removal of an intracorporeal VAD. Use 33997 for removal of a percutaneous right-heart device.
The same code, a different location
How does Madera compare?
33997 across payment areas
Same release and payment basis · bars start at $0
Madera · 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.
No comparable rate is available in this setting.
Other payment areas listed in California 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
Merced
California · 33997
Office
Unavailable
Facility
$132.76
No comparable office rate is available.
Modesto
California · 33997
Office
Unavailable
Facility
$132.76
No comparable office rate is available.
Napa
California · 33997
Office
Unavailable
Facility
$140.93
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 33997
Office
Unavailable
Facility
$137.45
No comparable office rate is available.
Redding
California · 33997
Office
Unavailable
Facility
$132.76
No comparable office rate is available.
Rest Of California
California · 33997
Office
Unavailable
Facility
$132.76
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 33997
Office
Unavailable
Facility
$139.95
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 33997
Office
Unavailable
Facility
$135.91
No comparable office rate is available.
Salinas
California · 33997
Office
Unavailable
Facility
$135.35
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 33997
Office
Unavailable
Facility
$136.10
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 33997
Office
Unavailable
Facility
$144.75
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 33997
Office
Unavailable
Facility
$143.99
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 33997
Office
Unavailable
Facility
$148.56
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 33997
Office
Unavailable
Facility
$145.45
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 33997
Office
Unavailable
Facility
$133.59
No comparable office rate is available.
Santa Cruz-Watsonville
California · 33997
Office
Unavailable
Facility
$135.45
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 33997
Office
Unavailable
Facility
$135.19
No comparable office rate is available.
Santa Rosa-Petaluma
California · 33997
Office
Unavailable
Facility
$136.58
No comparable office rate is available.
Stockton
California · 33997
Office
Unavailable
Facility
$132.76
No comparable office rate is available.
Vallejo
California · 33997
Office
Unavailable
Facility
$139.83
No comparable office rate is available.
Visalia
California · 33997
Office
Unavailable
Facility
$132.76
No comparable office rate is available.
Yuba City
California · 33997
Office
Unavailable
Facility
$132.76
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 33997
Office
Unavailable
Facility
$150.88
No comparable office rate is available.
Miami
Florida · 33997
Office
Unavailable
Facility
$174.63
No comparable office rate is available.
Chicago
Illinois · 33997
Office
Unavailable
Facility
$169.38
No comparable office rate is available.
Manhattan
New York · 33997
Office
Unavailable
Facility
$162.13
No comparable office rate is available.
Alaska*
Alaska · 33997
Office
Unavailable
Facility
$179.76
No comparable office rate is available.
Alabama
Alabama · 33997
Office
Unavailable
Facility
$127.48
No comparable office rate is available.
Arkansas
Arkansas · 33997
Office
Unavailable
Facility
$126.03
No comparable office rate is available.
Arizona
Arizona · 33997
Office
Unavailable
Facility
$135.79
No comparable office rate is available.
Colorado
Colorado · 33997
Office
Unavailable
Facility
$137.13
No comparable office rate is available.
Connecticut
Connecticut · 33997
Office
Unavailable
Facility
$147.76
No comparable office rate is available.
Delaware
Delaware · 33997
Office
Unavailable
Facility
$137.61
No comparable office rate is available.
Fort Lauderdale
Florida · 33997
Office
Unavailable
Facility
$157.95
No comparable office rate is available.
Rest Of Florida
Florida · 33997
Office
Unavailable
Facility
$150.02
No comparable office rate is available.
Atlanta
Georgia · 33997
Office
Unavailable
Facility
$144.72
No comparable office rate is available.
Rest Of Georgia
Georgia · 33997
Office
Unavailable
Facility
$141.82
No comparable office rate is available.
Hawaii, Guam
Hawaii · 33997
Office
Unavailable
Facility
$132.85
No comparable office rate is available.
Iowa
Iowa · 33997
Office
Unavailable
Facility
$124.47
No comparable office rate is available.
Idaho
Idaho · 33997
Office
Unavailable
Facility
$126.27
No comparable office rate is available.
East St. Louis
Illinois · 33997
Office
Unavailable
Facility
$160.76
No comparable office rate is available.
Rest Of Illinois
Illinois · 33997
Office
Unavailable
Facility
$150.53
No comparable office rate is available.
Suburban Chicago
Illinois · 33997
Office
Unavailable
Facility
$158.10
No comparable office rate is available.
Indiana
Indiana · 33997
Office
Unavailable
Facility
$126.70
No comparable office rate is available.
Kansas
Kansas · 33997
Office
Unavailable
Facility
$126.66
No comparable office rate is available.
Kentucky
Kentucky · 33997
Office
Unavailable
Facility
$135.56
No comparable office rate is available.
New Orleans
Louisiana · 33997
Office
Unavailable
Facility
$141.52
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 33997
Office
Unavailable
Facility
$136.45
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 33997
Office
Unavailable
Facility
$144.92
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 33997
Office
Unavailable
Facility
$137.67
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 33997
Office
Unavailable
Facility
$147.90
No comparable office rate is available.
Rest Of Maryland
Maryland · 33997
Office
Unavailable
Facility
$138.99
No comparable office rate is available.
Rest Of Maine
Maine · 33997
Office
Unavailable
Facility
$129.61
No comparable office rate is available.
Southern Maine
Maine · 33997
Office
Unavailable
Facility
$131.18
No comparable office rate is available.
Detroit
Michigan · 33997
Office
Unavailable
Facility
$154.29
No comparable office rate is available.
Rest Of Michigan
Michigan · 33997
Office
Unavailable
Facility
$140.82
No comparable office rate is available.
Minnesota
Minnesota · 33997
Office
Unavailable
Facility
$124.42
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 33997
Office
Unavailable
Facility
$137.92
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 33997
Office
Unavailable
Facility
$138.73
No comparable office rate is available.
Rest Of Missouri
Missouri · 33997
Office
Unavailable
Facility
$136.36
No comparable office rate is available.
Mississippi
Mississippi · 33997
Office
Unavailable
Facility
$131.08
No comparable office rate is available.
Montana**
Montana · 33997
Office
Unavailable
Facility
$139.57
No comparable office rate is available.
North Carolina
North Carolina · 33997
Office
Unavailable
Facility
$130.24
No comparable office rate is available.
North Dakota**
North Dakota · 33997
Office
Unavailable
Facility
$126.32
No comparable office rate is available.
Nebraska
Nebraska · 33997
Office
Unavailable
Facility
$124.20
No comparable office rate is available.
New Hampshire
New Hampshire · 33997
Office
Unavailable
Facility
$137.61
No comparable office rate is available.
Northern Nj
New Jersey · 33997
Office
Unavailable
Facility
$150.40
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 33997
Office
Unavailable
Facility
$147.48
No comparable office rate is available.
New Mexico
New Mexico · 33997
Office
Unavailable
Facility
$142.51
No comparable office rate is available.
Nevada**
Nevada · 33997
Office
Unavailable
Facility
$135.90
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 33997
Office
Unavailable
Facility
$168.72
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 33997
Office
Unavailable
Facility
$150.56
No comparable office rate is available.
Queens
New York · 33997
Office
Unavailable
Facility
$159.30
No comparable office rate is available.
Rest Of New York
New York · 33997
Office
Unavailable
Facility
$132.00
No comparable office rate is available.
Ohio
Ohio · 33997
Office
Unavailable
Facility
$138.11
No comparable office rate is available.
Oklahoma
Oklahoma · 33997
Office
Unavailable
Facility
$132.55
No comparable office rate is available.
Portland
Oregon · 33997
Office
Unavailable
Facility
$137.60
No comparable office rate is available.
Rest Of Oregon
Oregon · 33997
Office
Unavailable
Facility
$132.89
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 33997
Office
Unavailable
Facility
$146.49
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 33997
Office
Unavailable
Facility
$136.80
No comparable office rate is available.
Puerto Rico
Puerto Rico · 33997
Office
Unavailable
Facility
$139.49
No comparable office rate is available.
Rhode Island
Rhode Island · 33997
Office
Unavailable
Facility
$139.70
No comparable office rate is available.
South Carolina
South Carolina · 33997
Office
Unavailable
Facility
$134.79
No comparable office rate is available.
South Dakota**
South Dakota · 33997
Office
Unavailable
Facility
$124.76
No comparable office rate is available.
Tennessee
Tennessee · 33997
Office
Unavailable
Facility
$127.49
No comparable office rate is available.
Austin
Texas · 33997
Office
Unavailable
Facility
$138.38
No comparable office rate is available.
Beaumont
Texas · 33997
Office
Unavailable
Facility
$136.28
No comparable office rate is available.
Brazoria
Texas · 33997
Office
Unavailable
Facility
$135.30
No comparable office rate is available.
Dallas
Texas · 33997
Office
Unavailable
Facility
$137.24
No comparable office rate is available.
Fort Worth
Texas · 33997
Office
Unavailable
Facility
$137.34
No comparable office rate is available.
Galveston
Texas · 33997
Office
Unavailable
Facility
$136.41
No comparable office rate is available.
Houston
Texas · 33997
Office
Unavailable
Facility
$148.68
No comparable office rate is available.
Rest Of Texas
Texas · 33997
Office
Unavailable
Facility
$136.46
No comparable office rate is available.
Utah
Utah · 33997
Office
Unavailable
Facility
$136.17
No comparable office rate is available.
Virginia
Virginia · 33997
Office
Unavailable
Facility
$132.71
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 33997
Office
Unavailable
Facility
$139.49
No comparable office rate is available.
Vermont
Vermont · 33997
Office
Unavailable
Facility
$128.37
No comparable office rate is available.
Rest Of Washington
Washington · 33997
Office
Unavailable
Facility
$136.57
No comparable office rate is available.
Seattle (King Cnty)
Washington · 33997
Office
Unavailable
Facility
$144.81
No comparable office rate is available.
Wisconsin
Wisconsin · 33997
Office
Unavailable
Facility
$123.32
No comparable office rate is available.
West Virginia
West Virginia · 33997
Office
Unavailable
Facility
$146.72
No comparable office rate is available.
Wyoming**
Wyoming · 33997
Office
Unavailable
Facility
$133.80
No comparable office rate is available.
See how rates vary across the country
33997 · 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?
Madera is a Medicare payment area. Our Census mapping connects it to 17 cities and communities in California, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 33997 in Madera. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$146.04
$132.76 × 110% = $146.04
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 33997 in Madera.
PPRRVU2026_Oct_nonQPP.csv
4,179
- Code
- 33997
- Physician work
- 2.93
- Practice expense
- 0.58
- Malpractice
- 0.67
GPCI2026.csv
14
- Locality
- Madera
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.93 | × 1.017 | 2.9798 |
| Practice expense | 0.58 | × 1.096 | 0.6357 |
| Malpractice | 0.67 | × 0.536 | 0.3591 |
| Total RVUs | 3.9746 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Madera$132.76
Open 33997 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1.017 |
| Practice expense | 0.58 | 1.096 |
| Malpractice | 0.67 | 0.536 |
(2.93 × 1.017 + 0.58 × 1.096 + 0.67 × 0.536) × $33.4009 = $132.76
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
33997 · 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 | $132.76 | RVU26D |
| 2026-07-01 | Not available in this setting | $132.76 | RVU26C |
| 2026-04-01 | Not available in this setting | $132.76 | RVU26B |
| 2026-01-01 | Not available in this setting | $132.76 | RVU26A |
| 2025-10-01 | Not available in this setting | $147.67 | RVU25D |
| 2025-07-01 | Not available in this setting | $147.67 | RVU25C |
| 2025-04-01 | Not available in this setting | $147.67 | RVU25B |
| 2025-01-01 | Not available in this setting | $147.67 | RVU25A |
33997 billing questions
How is this different from 33992?
33997 is for removal of a percutaneous right-heart VAD. Code 33992 is the corresponding removal code for a percutaneous left-heart VAD.
Should removal be reported with repositioning?
Use 33997 when the device is removed. Code 33993 describes repositioning a percutaneous right- or left-heart VAD, not removal.
What documentation supports 33997?
Document the percutaneous right-heart device, its removal, and the clinical reason it was taken out. The record should distinguish removal from repositioning or removal of a different VAD configuration.
Can an assistant surgeon be reported?
CMS permits assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
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.
Is modifier 50 appropriate?
No. The service concerns a single right-heart device, so the descriptor and anatomy make modifier 50 inappropriate.
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.
4,17633992,,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
4,17833995,,Insj perq vad r hrt venous,A,,6.58,1.28,NA,1.28,,1.50,9.36,9.36,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17933997,,Rmvl perq right heart vad,A,,2.93,0.58,NA,0.58,,0.67,4.18,4.18,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,18033999,,Unlisted px cardiac surgery,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,18134001,,Removal of artery clot,A,,17.43,3.11,NA,3.11,,4.46,25.00,25.00,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,18234051,,Removal of artery clot,A,,16.57,8.37,NA,8.37,,3.96,28.90,28.90,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508