No office rate
33990 describes insertion of a percutaneous left-heart VAD through arterial access; 33992 describes its removal.
On this page
CMS RVU26D · Effective 2026-10-01
33992 VAD removal Medicare reimbursement rates in Mississippi
Removal of a percutaneously placed left-heart ventricular assist device is reported when temporary mechanical circulatory support is discontinued. Compare 33992 office and facility rates across CMS payment localities in Mississippi.
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 33992 in Mississippi?
Mississippi 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
$154.79
1 of 1 localities have a supported rate.
Payment area: Mississippi
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.
Cardiac surgery
About 33992: Percutaneous left-heart VAD removal
Removal of a percutaneously placed left-heart ventricular assist device is reported when temporary mechanical circulatory support is discontinued.
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.
CMS billing rules for 33992
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.46 · 70%
- Practice expense (office) RVU0.66 · 13%
- Malpractice RVU0.82 · 17%
2.7K
Medicare services in 2024 · #2256 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.
33992 compared with similar codes
Office rates for Mississippi, from the same CMS release.
No office rate
33991 describes percutaneous left-heart VAD insertion using arterial and venous access. It is not the removal service represented by 33992.
No office rate
33997 is for removal of a percutaneous right-heart VAD; 33992 is for a percutaneous left-heart VAD.
No office rate
33989 describes removal of a left-heart vent. Select 33992 when the removed device is a percutaneous left-heart VAD.
Compare 33992 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
Mississippi →
Office / nonfacility
Unavailable
Facility
$154.79
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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 33992 in Mississippi.
PPRRVU2026_Oct_nonQPP.csv
4,176
- Code
- 33992
- Physician work
- 3.46
- Practice expense
- 0.66
- Malpractice
- 0.82
GPCI2026.csv
67
- Locality
- Mississippi
- Physician work
- 1.000
- Practice expense
- 0.861
- Malpractice
- 0.739
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.46 | × 1.000 | 3.4600 |
| Practice expense | 0.66 | × 0.861 | 0.5683 |
| Malpractice | 0.82 | × 0.739 | 0.6060 |
| Total RVUs | 4.6342 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Mississippi$154.79
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.46 | 1 |
| Practice expense | 0.66 | 0.861 |
| Malpractice | 0.82 | 0.739 |
(3.46 × 1 + 0.66 × 0.861 + 0.82 × 0.739) × $33.4009 = $154.79
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.
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 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.
4,17333989,,Removal of left heart vent,A,,9.26,2.05,NA,2.05,,2.21,13.52,13.52,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17433990,,Insj perq vad l hrt arterial,A,,6.58,1.26,NA,1.26,,1.53,9.37,9.37,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17533991,,Insj perq vad l hrt artl&ven,A,,8.62,1.77,NA,1.77,,2.06,12.45,12.45,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17633992,,Rmvl perq left heart vad,A,,3.46,0.66,NA,0.66,,0.82,4.94,4.94,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17733993,,Reposg perq r/l hrt vad,A,,3.02,0.66,NA,0.66,,0.58,4.26,4.26,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17833995,,Insj perq vad r hrt venous,A,,6.58,1.28,NA,1.28,,1.50,9.36,9.36,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17933997,,Rmvl perq right heart vad,A,,2.93,0.58,NA,0.58,,0.67,4.18,4.18,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974