Billing code 33978: VAD removalMedicare rate & RVUs in Alaska
Reports surgical removal of an extracorporeal ventricular assist device supporting one ventricle, such as after temporary mechanical circulatory support is no longer needed.
CMS doesn’t publish an office rate for 33978 in Alaska.
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 9 sections
What 33978 covers
billing code 33978 describes removal of an extracorporeal ventricular assist device that has supported a single ventricle. A cardiac surgeon may perform the procedure when a patient’s heart function has recovered enough to discontinue temporary mechanical support. The operation takes place in a surgical setting and addresses removal of the device used for ventricular support, rather than removal of an implantable intracorporeal pump or an intra-aortic balloon device.
Choose this code when the operative record identifies removal of an extracorporeal device supporting one ventricle. Documentation should establish the device type, the supported ventricle or ventricles, and that removal was performed. When other procedures occur during the same session, CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full and the others at 50%. CMS pricing treats this service as bilateral; modifier 50 does not increase payment.
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.
33978 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $1,571.19 |
How the 33978 rate is calculated
Each of 33978’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 · 33978
RVUs × geographic indexes × conversion factor
Work24.38
24.38 RVUs× 1.000 GPCI
Practice expense6.81
6.81 RVUs× 1.000 GPCI
Malpractice5.84
5.84 RVUs× 1.000 GPCI
Adjusted RVUs
37.0300
Conversion factor
$33.4009
Medicare rate
$1,236.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33978
The CMS indicators that decide how 33978 is paid alongside other services.
CMS payment indicators · 33978
VAD removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33978 without 51 · national facility
$1,236.84
VAD removal
33978-51 · Second procedure: 50%
$618.42
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%).
33978 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33977VAD removal
- Use 33978 for removal of an extracorporeal device supporting one ventricle; use 33977 when the device supported both ventricles.
- 33980VAD removal
- 33978 is for an extracorporeal device. 33980 is for removal of an implantable intracorporeal ventricular assist device.
- 33976Ventricular assist device
- 33976 reports insertion of an extracorporeal ventricular assist device supporting one ventricle; 33978 reports removal of that device type.
33978 billing questions
How does 33978 differ from 33977?
33978 is for removal of an extracorporeal ventricular assist device supporting one ventricle. 33977 is the corresponding removal code for a device supporting both ventricles.
Is this the code for removing an implanted VAD?
No. 33978 covers an extracorporeal device; 33980 describes removal of an implantable intracorporeal ventricular assist device.
Should modifier 50 be added?
CMS pricing already treats 33978 as bilateral, and modifier 50 does not increase payment.
How does the multiple procedure reduction affect 33978?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. The reduction depends on how 33978 ranks among the procedures performed.
What documentation supports reporting 33978?
The operative report should identify the extracorporeal ventricular assist device, confirm that it supported one ventricle, and describe its 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
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