No office rate
Use 33970 for open transthoracic insertion; use 33967 when insertion is performed percutaneously.
On this page
CMS RVU26D · Effective 2026-10-01
33970 Aortic assist device Medicare reimbursement rates in Iowa
Reports open placement of an intra-aortic balloon assist device through a transthoracic approach to provide temporary circulatory support. Compare 33970 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 33970 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$279.08
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Cardiovascular surgery
About 33970: Open transthoracic aortic balloon placement
Reports open placement of an intra-aortic balloon assist device through a transthoracic approach to provide temporary circulatory support.
This service is open placement of an intra-aortic balloon assist device through the chest, with access to the aorta for temporary circulatory support. It is generally performed by a cardiothoracic surgeon in an operating room for a patient who needs mechanical support, often in the setting of severe cardiac dysfunction or cardiac surgery. The approach distinguishes this service from percutaneous balloon-pump insertion.
Report the code for the open transthoracic insertion, supported by an operative report documenting the approach, device placement, and clinical purpose. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this single aortic device service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33970
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.57 · 70%
- Practice expense (office) RVU1.27 · 13%
- Malpractice RVU1.57 · 17%
322
Medicare services in 2024 · #3943 by national volume
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.
33970 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
33970 reports open transthoracic insertion, while 33971 reports removal through that approach.
No office rate
Both concern intra-aortic balloon device insertion, but 33973 represents a different approach; select the code matching the operative approach.
Compare 33970 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$279.08
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33970 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
4,155
- Code
- 33970
- Physician work
- 6.57
- Practice expense
- 1.27
- Malpractice
- 1.57
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.57 | × 1.000 | 6.5700 |
| Practice expense | 1.27 | × 0.915 | 1.1621 |
| Malpractice | 1.57 | × 0.397 | 0.6233 |
| Total RVUs | 8.3553 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$279.08
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.57 | 1 |
| Practice expense | 1.27 | 0.915 |
| Malpractice | 1.57 | 0.397 |
(6.57 × 1 + 1.27 × 0.915 + 1.57 × 0.397) × $33.4009 = $279.08
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
33970 billing questions
How is this different from 33967?
33970 describes open placement through a transthoracic approach. 33967 is the percutaneous insertion code.
Is removal included in this code?
No. Removal is a separate service; 33971 describes removal through the open transthoracic approach.
Should modifier 50 be appended?
No. The service concerns placement of one aortic assist device, so modifier 50 is inappropriate.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple procedure reduction.
What documentation supports reporting 33970?
The operative report should identify the open transthoracic approach, placement of the intra-aortic balloon assist device, and the reason circulatory support was needed.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,15233967,,Insert i-aort percut device,A,,4.72,0.92,NA,0.92,,1.09,6.73,6.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15333968,,Remove aortic assist device,A,,0.62,0.13,NA,0.13,,0.14,0.89,0.89,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15433969,,Ecmo/ecls rmvl perph cannula,A,,5.09,1.19,NA,1.19,,1.22,7.50,7.50,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15533970,,Aortic circulation assist,A,,6.57,1.27,NA,1.27,,1.57,9.41,9.41,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15633971,,Aortic circulation assist,A,,11.69,5.64,NA,5.64,,2.77,20.10,20.10,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15733973,,Insert balloon device,A,,9.51,1.95,NA,1.95,,2.27,13.73,13.73,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15833974,,Remove intra-aortic balloon,A,,14.65,7.95,NA,7.95,,3.50,26.10,26.10,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136