Billing code 33997: VAD removalMedicare rate & RVUs in Alaska
Removal of a percutaneously placed right-heart ventricular assist device, typically after temporary mechanical support for acute right ventricular failure is no longer needed.
CMS doesn’t publish an office rate for 33997 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 33997 covers
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.
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 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $179.76 |
How the 33997 rate is calculated
Each of 33997’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 · 33997
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.93Practice expense 0.58Malpractice 0.67
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33997
The CMS indicators that decide how 33997 is paid alongside other services.
CMS payment indicators · 33997
VAD removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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
33997 without 51 · national facility
$139.62
VAD removal
33997-51 · Second procedure: 50%
$69.81
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%).
33997 compared with similar codes
Compare codes
33997 vs 33992 vs 33993 vs 33995 vs 33980: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33992VAD removal
- Choose 33997 for percutaneous right-heart VAD removal; 33992 is for percutaneous left-heart VAD removal.
- 33993VAD repositioning
- 33993 represents repositioning a percutaneous right- or left-heart VAD. Report 33997 when the right-heart device is removed.
- 33995VAD insertion
- 33995 is for placing percutaneous right-heart VAD support; 33997 is for taking that type of device out.
- 33980VAD removal
- 33980 concerns removal of an intracorporeal VAD. Use 33997 for removal of a percutaneous right-heart device.
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 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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