Billing code 33995: VAD insertionMedicare rate & RVUs in Illinois
Reports percutaneous placement of a venous right heart assist device to provide temporary mechanical support when right ventricular function is inadequate.
CMS doesn’t publish an office rate for 33995 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 33995 covers
billing code 33995 reports percutaneous placement of a ventricular assist device to support the right heart. An interventional cardiologist or cardiac surgeon typically advances the device through venous access and positions it to provide right-sided circulatory support. Placement is generally performed in a hospital setting, such as a catheterization laboratory, for patients who need temporary mechanical support because of right ventricular failure. The service includes the imaging guidance and interpretation associated with device placement.
Select this code for percutaneous right heart device insertion, rather than insertion of a left heart device. The operative report should identify the support indication, venous access, device placement, and imaging used to confirm position. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate for this code. 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.
Where 33995 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 | $379.27 |
| East St. Louis | Unavailable | $360.01 |
| Rest Of Illinois | Unavailable | $337.12 |
| Suburban Chicago | Unavailable | $354.00 |
How the 33995 rate is calculated
Each of 33995’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 · 33995
RVUs × geographic indexes × conversion factor
Work6.58
6.58 RVUs× 1.000 GPCI
Practice expense1.28
1.28 RVUs× 1.000 GPCI
Malpractice1.50
1.50 RVUs× 1.000 GPCI
Adjusted RVUs
9.3600
Conversion factor
$33.4009
Medicare rate
$312.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33995
The CMS indicators that decide how 33995 is paid alongside other services.
CMS payment indicators · 33995
VAD insertion
| 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
33995 without 51 · national facility
$312.63
VAD insertion
33995-51 · Second procedure: 50%
$156.32
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%).
33995 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33990VAD insertion
- Choose 33990 for percutaneous left heart device insertion with arterial access only; 33995 is for right heart support through venous access.
- 33991VAD insertion
- Choose 33991 for percutaneous left heart device insertion using arterial and venous access. The right heart insertion is reported with 33995.
- 33997VAD removal
- 33997 describes removal of a percutaneous right heart assist device, not its initial insertion.
- 33993VAD repositioning
- 33993 is for repositioning a percutaneous right or left heart device; 33995 is for right heart device insertion.
33995 billing questions
How does 33995 differ from 33990 or 33991?
33995 is for percutaneous right heart support through venous access. Codes 33990 and 33991 describe percutaneous left heart device insertion, distinguished by their access configuration.
Is 33995 used for device removal or repositioning?
No. Report 33995 for insertion; 33997 describes removal of a percutaneous right heart device, and 33993 describes repositioning a percutaneous right or left heart device.
What documentation supports reporting 33995?
Document the right-sided support indication, venous access, device insertion and final position, and the imaging used during placement.
Can modifier 50 be appended for bilateral work?
No. The code’s anatomy and descriptor make bilateral adjustment inappropriate, so modifier 50 should not be used.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted for this code.
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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