Billing code 33977: VAD removalMedicare rate & RVUs in Delaware
Reports operative removal of an extracorporeal ventricular assist device supporting one ventricle, such as when temporary mechanical support is no longer needed.
CMS doesn’t publish an office rate for 33977 in Delaware.
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 33977 covers
This code covers surgery to remove an extracorporeal ventricular assist device that has been supporting a single ventricle. A cardiac or cardiothoracic surgeon typically performs the removal in a hospital operating room after the patient’s need for temporary mechanical circulatory support has ended. The code distinguishes this device and support configuration from an intracorporeal VAD and from extracorporeal support for both ventricles.
Select the code when the operative record identifies an extracorporeal device, support of one ventricle, and its removal. Documentation should establish the device type and the removal performed; the code is not selected by the length of support. Under the CMS multiple-procedure rule, when this service is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
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.
33977 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $1,019.84 |
How the 33977 rate is calculated
Each of 33977’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 · 33977
RVUs × geographic indexes × conversion factor
Work20.34
20.34 RVUs× 1.000 GPCI
Practice expense5.71
5.71 RVUs× 1.000 GPCI
Malpractice4.95
4.95 RVUs× 1.000 GPCI
Adjusted RVUs
31.0000
Conversion factor
$33.4009
Medicare rate
$1,035.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33977
The CMS indicators that decide how 33977 is paid alongside other services.
CMS payment indicators · 33977
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) | 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
33977 without 51 · national facility
$1,035.43
VAD removal
33977-51 · Second procedure: 50%
$517.72
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%).
33977 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33978VAD removal
- Choose 33977 for extracorporeal support of one ventricle and 33978 for extracorporeal support of both ventricles.
- 33980VAD removal
- 33980 describes removal of an intracorporeal VAD; 33977 is for an extracorporeal device supporting one ventricle.
- 33975Ventricular assist device
- 33975 is for placing an extracorporeal VAD to support one ventricle. 33977 describes removal of that type of support.
33977 billing questions
How does 33977 differ from 33978?
33977 is for removal of an extracorporeal VAD supporting one ventricle. 33978 is the corresponding removal code for biventricular support.
When is 33980 more appropriate?
Use 33980 for removal of an intracorporeal VAD. Code 33977 describes an extracorporeal device supporting a single ventricle.
What should the operative note document?
Document that the device was extracorporeal, that it supported one ventricle, and that the service included its operative removal.
Is 33977 selected by operative time?
No. The code is selected by the device configuration and removal performed, not by elapsed time.
How is 33977 paid when other procedures are performed in the same session?
The highest-valued procedure is paid in full; the other procedures are subject to the standard multiple-procedure reduction to 50%.
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
Fee sheets
Put 33977 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →