Billing code 0597T: Pump replacementMedicare rate & RVUs in Oregon
Reports replacement of a temporary femoral intravascular valve-pump during a procedural encounter, rather than its initial placement.
Medicare pays $593.70–$658.78 for 0597T in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.
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 0597T covers
This Category III service represents replacing a temporary intravascular valve-pump introduced through femoral access. It is a device procedure performed by a physician involved in cardiovascular or endovascular intervention, typically in a procedural setting. The replacement is distinct from the device’s initial insertion and should be supported by documentation identifying the existing pump and the exchange performed.
Report 0597T when the documented service is replacement, not first insertion. The record should describe the reason for the exchange, the device and access site, and the procedural work. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. The code is not a bilateral service, so modifier 50 is not appropriate. Medicare does not pay an assistant at surgery for this service; 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 0597T pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $658.78 | $55.40 |
| Rest Of Oregon | $593.70 | $52.78 |
How the 0597T rate is calculated
Each of 0597T’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 · 0597T
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.02Practice expense 16.78Malpractice 0.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 0597T
The CMS indicators that decide how 0597T is paid alongside other services.
CMS payment indicators · 0597T
Pump replacement
| 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) | 1 | Not paid (statutory restriction). |
| 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
0597T without 51 · national office
$596.54
Pump replacement
0597T-51 · Second procedure: 50%
$298.27
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%).
0597T compared with similar codes
Compare codes
0597T vs 0596T vs 33990 vs 33991: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 0596TIntraurethral pump
- Use 0596T for the pump’s first insertion. Use 0597T when an existing temporary femoral intravascular valve-pump is replaced.
- 33990VAD insertion
- 33990 describes a percutaneous ventricular-assist device insertion using arterial access. It is not the replacement service represented by 0597T.
- 33991VAD insertion
- 33991 describes a percutaneous ventricular-assist device insertion using arterial and venous access. Choose 0597T only for replacement of the specified temporary femoral valve-pump.
0597T billing questions
How is 0597T different from 0596T?
0596T describes the first insertion of the temporary femoral intravascular valve-pump. Use 0597T when the documented procedure replaces an existing pump.
Should modifier 50 be reported for replacement on both sides?
No. This code describes a procedure that is not reported as a bilateral service, so modifier 50 is inappropriate.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure’s 0-day global period.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
What should the procedure note document?
Identify the temporary pump already in place, the femoral access site, and the replacement performed. Document the reason for the exchange and the device involved.
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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