Billing code 33927: Artificial heartMedicare rate & RVUs in Guam
Report total artificial heart implantation, including removal of the recipient’s heart, for patients requiring complete ventricular replacement.
CMS doesn’t publish an office rate for 33927 in Guam.
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 33927 covers
This operation implants a total replacement heart system, an artificial heart that takes over the pumping work of both ventricles. The procedure includes cardiectomy, or removal of the recipient’s heart. Cardiothoracic surgeons perform it in an operating room, generally for patients with end-stage biventricular failure who need complete ventricular support, often while awaiting transplantation. It is distinct from implanting a ventricular assist device that supports only one ventricle.
Report 33927 for the initial implantation with recipient cardiectomy, not for later removal and replacement of an existing system. The operative report should identify the indication, removal of the recipient’s heart, and implantation of the total replacement heart system. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50% under the standard multiple-procedure rule.
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.
33927 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $2,186.87 |
How the 33927 rate is calculated
Each of 33927’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 · 33927
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 47.78Practice expense 9.42Malpractice 12.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33927
The CMS indicators that decide how 33927 is paid alongside other services.
CMS payment indicators · 33927
Artificial heart
| 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
33927 without 51 · national facility
$2,313.35
Artificial heart
33927-51 · Second procedure: 50%
$1,156.68
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%).
33927 compared with similar codes
Compare codes
33927 vs 33928 vs 33929 vs 33945: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33928Rmvl & rplcmt tot hrt sys
- 33927 describes initial implantation with recipient cardiectomy. 33928 is for removing and replacing a total replacement heart system already in place.
- 33929Rmvl rplcmt hrt sys f/trnspl
- 33927 is the initial total artificial heart implant. 33929 describes removal and replacement of the system in the heart-transplant setting.
- 33945Transplantation of heart
- 33945 reports transplantation of a donor heart. 33927 reports implantation of a total artificial heart, including recipient cardiectomy.
33927 billing questions
How does 33927 differ from 33928?
Use 33927 for initial implantation of a total replacement heart system with recipient cardiectomy. Code 33928 describes removal and replacement of an existing total heart system.
Does 33927 include removal of the recipient’s heart?
Yes. Recipient cardiectomy is included in the implantation service.
Is this the code for an LVAD implant?
No. 33927 is for a total artificial heart replacing the pumping function of both ventricles; an LVAD supports the left ventricle.
What documentation supports 33927?
The operative report should establish that this was an initial total artificial heart implantation and document recipient cardiectomy and placement of the replacement system.
How does Medicare handle another procedure performed in the same session?
Under the standard multiple-procedure reduction, Medicare pays the highest-valued procedure in full and pays the other procedures at 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
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