Billing code 33992: VAD removalMedicare rate & RVUs in Illinois
Removal of a percutaneously placed left-heart ventricular assist device is reported when temporary mechanical circulatory support is discontinued.
CMS doesn’t publish an office rate for 33992 in Illinois.
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 33992 covers
This service covers withdrawing a catheter-based ventricular assist device used to support the left heart. It is commonly performed by an interventional cardiologist or cardiac surgeon in a catheterization laboratory or other procedural setting when the patient’s hemodynamic condition allows temporary support to end. The code identifies removal of the percutaneous left-heart device, rather than implantation, repositioning, or removal of a right-heart device.
Report the code when the documented service removes that percutaneous left-heart VAD; the record should identify the device and support the removal performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this descriptor. Assistant-at-surgery services may be paid; 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.
Where 33992 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $201.39 |
| East St. Louis | Unavailable | $191.01 |
| Rest Of Illinois | Unavailable | $178.50 |
| Suburban Chicago | Unavailable | $187.55 |
How the 33992 rate is calculated
Each of 33992’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 · 33992
RVUs × geographic indexes × conversion factor
Work3.46
3.46 RVUs× 1.000 GPCI
Practice expense0.66
0.66 RVUs× 1.000 GPCI
Malpractice0.82
0.82 RVUs× 1.000 GPCI
Adjusted RVUs
4.9400
Conversion factor
$33.4009
Medicare rate
$165.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33992
The CMS indicators that decide how 33992 is paid alongside other services.
CMS payment indicators · 33992
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
33992 without 51 · national facility
$165.00
VAD removal
33992-51 · Second procedure: 50%
$82.50
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%).
33992 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33990VAD insertion
- 33990 describes insertion of a percutaneous left-heart VAD through arterial access; 33992 describes its removal.
- 33991VAD insertion
- 33991 describes percutaneous left-heart VAD insertion using arterial and venous access. It is not the removal service represented by 33992.
- 33997VAD removal
- 33997 is for removal of a percutaneous right-heart VAD; 33992 is for a percutaneous left-heart VAD.
- 33989Heart vent removal
- 33989 describes removal of a left-heart vent. Select 33992 when the removed device is a percutaneous left-heart VAD.
33992 billing questions
How is removal distinguished from repositioning?
Report 33992 when the percutaneous left-heart VAD is removed. Code 33993 describes repositioning a percutaneous right- or left-heart VAD, not removal.
Is 33992 used for VAD insertion?
No. Codes 33990 and 33991 describe percutaneous left-heart VAD insertion, with different access configurations; 33992 describes removal.
When does 33997 apply instead?
Use 33997 for removal of a percutaneous right-heart VAD. Code 33992 is specific to a percutaneous left-heart VAD.
Can modifier 50 be used for this removal?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the multiple procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
What documentation supports reporting 33992?
Document that the device was a percutaneous left-heart VAD and that it was removed. The record should distinguish removal from repositioning or removal of a right-heart device.
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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