Billing code 33989: Heart vent removalMedicare rate & RVUs in Guam
Report removal of a left heart vent used to decompress the heart during cardiac surgery, typically when the vent is withdrawn after its use.
CMS doesn’t publish an office rate for 33989 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 33989 covers
A left heart vent is a temporary tube or cannula used during cardiac surgery to decompress the left side of the heart. A cardiac surgeon typically removes it in the operating room after it is no longer needed, often as the operation and support period are concluding. This service concerns removal of the vent, not removal of a ventricular assist device or other circulatory support device.
Report the removal when documentation identifies the left heart vent and its removal. Code 33988 describes insertion of the vent; the operative record should support the distinct service performed. CMS assigns a 0-day global period, 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 50% multiple-procedure reduction. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment require supporting documentation.
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.
33989 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $429.88 |
How the 33989 rate is calculated
Each of 33989’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 · 33989
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.26Practice expense 2.05Malpractice 2.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33989
The CMS indicators that decide how 33989 is paid alongside other services.
CMS payment indicators · 33989
Heart vent 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33989 without 51 · national facility
$451.58
Heart vent removal
33989-51 · Second procedure: 50%
$225.79
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%).
33989 compared with similar codes
Compare codes
33989 vs 33988 vs 33992 vs 33977: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33988Left heart vent
- 33988 reports insertion of a left heart vent; 33989 reports its removal. Use the operative documentation to identify the service performed.
- 33992VAD removal
- 33992 describes removal of a percutaneous left heart ventricular assist device. Code 33989 is for removal of a left heart vent.
- 33977VAD removal
- 33977 describes removal of a ventricular assist device, not removal of a temporary left heart vent.
33989 billing questions
How is removal of a left heart vent different from 33988?
Code 33989 is for removing the vent; 33988 is for inserting it. The operative report should make clear which service was performed.
Is this code for removing a ventricular assist device?
No. It describes removal of a left heart vent, not a ventricular assist device. Codes such as 33992 and 33977 describe removal of different support devices.
What documentation supports reporting 33989?
Document that a left heart vent was present and removed, along with the operative circumstances. The record should distinguish the vent from a ventricular assist device.
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.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.
What documentation is needed for assistant or team surgery payment?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment require supporting documentation.
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 33989 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 →