Billing code 33976: Ventricular assist deviceMedicare rate & RVUs in Missouri
Reports surgical placement of an extracorporeal ventricular assist system supporting both ventricles, typically for temporary mechanical circulatory support in severe biventricular failure.
CMS doesn’t publish an office rate for 33976 in Missouri.
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 33976 covers
A cardiac surgeon places an extracorporeal ventricular assist system with cannulas connected to support both the right and left ventricles. The pump remains outside the body while providing temporary circulatory support, such as for a patient with severe biventricular failure who needs support while awaiting recovery or further treatment. The service is performed in a hospital operating room as part of surgical mechanical circulatory support.
Choose this code when the implanted system provides extracorporeal support to both ventricles; a single-ventricle extracorporeal system is a different code. The operative report should identify the device configuration and document support of both ventricles. CMS applies the standard multiple-procedure reduction when other qualifying procedures occur in the same session: the highest-valued procedure is paid in full and the others at 50%. The code is already priced as bilateral, so modifier 50 does not increase payment.
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 33976 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | Unavailable | $1,429.20 |
| Metropolitan St. Louis | Unavailable | $1,437.88 |
| Rest Of Missouri | Unavailable | $1,412.66 |
How the 33976 rate is calculated
Each of 33976’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 · 33976
RVUs × geographic indexes × conversion factor
Work29.98
29.98 RVUs× 1.000 GPCI
Practice expense6.15
6.15 RVUs× 1.000 GPCI
Malpractice7.20
7.20 RVUs× 1.000 GPCI
Adjusted RVUs
43.3300
Conversion factor
$33.4009
Medicare rate
$1,447.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33976
The CMS indicators that decide how 33976 is paid alongside other services.
CMS payment indicators · 33976
Ventricular assist device
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| 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
33976 without 51 · national facility
$1,447.26
Ventricular assist device
33976-51 · Second procedure: 50%
$723.63
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%).
33976 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33975Ventricular assist device
- Both codes describe extracorporeal ventricular assist device implantation. Choose 33976 for support of both ventricles and 33975 for single-ventricle support.
- 33979Ventricular assist device
- 33979 describes placement of an implantable intracorporeal device; 33976 describes an extracorporeal system supporting both ventricles.
- 33978VAD removal
- 33978 describes removal of an extracorporeal biventricular assist device, not its implantation.
33976 billing questions
How does 33976 differ from 33975?
33976 represents an extracorporeal system supporting both ventricles. Use 33975 for an extracorporeal system supporting a single ventricle.
How does 33976 differ from 33979?
33976 is for an extracorporeal biventricular system. Code 33979 describes an implantable intracorporeal ventricular assist device, a different device configuration.
Should modifier 50 be appended?
CMS identifies 33976 as already priced bilaterally. Modifier 50 does not increase payment.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other qualifying procedures are paid at 50%.
What documentation supports reporting 33976?
The operative report should identify the extracorporeal device and establish that it provides ventricular support to both sides of the heart.
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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