33928
No office rateRmvl & rplcmt tot hrt sys
33927 describes initial implantation with recipient cardiectomy. 33928 is for removing and replacing a total replacement heart system already in place.
On this page
CMS RVU26D · Effective 2026-10-01
33927 Artificial heart Medicare reimbursement rates in Rhode Island
Report total artificial heart implantation, including removal of the recipient’s heart, for patients requiring complete ventricular replacement. Compare 33927 office and facility rates across CMS payment localities in Rhode Island.
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 33927 in Rhode Island?
Rhode Island 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
$2310.55
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 33927: Total artificial heart implantation
Report total artificial heart implantation, including removal of the recipient’s heart, for patients requiring complete ventricular replacement.
This operation implants a total replacement heart system, an artificial heart that takes over the pumping work of both ventricles. The procedure includes cardiectomy, or removal of the recipient’s heart. Cardiothoracic surgeons perform it in an operating room, generally for patients with end-stage biventricular failure who need complete ventricular support, often while awaiting transplantation. It is distinct from implanting a ventricular assist device that supports only one ventricle.
Report 33927 for the initial implantation with recipient cardiectomy, not for later removal and replacement of an existing system. The operative report should identify the indication, removal of the recipient’s heart, and implantation of the total replacement heart system. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50% under the standard multiple-procedure rule.
CMS billing rules for 33927
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Where the value comes from
- Work RVU47.78 · 69%
- Practice expense (office) RVU9.42 · 14%
- Malpractice RVU12.06 · 17%
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.
33927 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
33929
No office rateRmvl rplcmt hrt sys f/trnspl
33927 is the initial total artificial heart implant. 33929 describes removal and replacement of the system in the heart-transplant setting.
33945
No office rateTransplantation of heart
33945 reports transplantation of a donor heart. 33927 reports implantation of a total artificial heart, including recipient cardiectomy.
Compare 33927 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$2310.55
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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 33927 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
4,123
- Code
- 33927
- Physician work
- 47.78
- Practice expense
- 9.42
- Malpractice
- 12.06
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 47.78 | × 1.019 | 48.6878 |
| Practice expense | 9.42 | × 1.033 | 9.7309 |
| Malpractice | 12.06 | × 0.892 | 10.7575 |
| Total RVUs | 69.1762 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$2310.55
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 47.78 | 1.019 |
| Practice expense | 9.42 | 1.033 |
| Malpractice | 12.06 | 0.892 |
(47.78 × 1.019 + 9.42 × 1.033 + 12.06 × 0.892) × $33.4009 = $2310.55
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.
33927 billing questions
How does 33927 differ from 33928?
Use 33927 for initial implantation of a total replacement heart system with recipient cardiectomy. Code 33928 describes removal and replacement of an existing total heart system.
Does 33927 include removal of the recipient’s heart?
Yes. Recipient cardiectomy is included in the implantation service.
Is this the code for an LVAD implant?
No. 33927 is for a total artificial heart replacing the pumping function of both ventricles; an LVAD supports the left ventricle.
What documentation supports 33927?
The operative report should establish that this was an initial total artificial heart implantation and document recipient cardiectomy and placement of the replacement system.
How does Medicare handle another procedure performed in the same session?
Under the standard multiple-procedure reduction, Medicare pays the highest-valued procedure in full and pays the other procedures at 50%.
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.
4,12033924,,Remove pulmonary shunt,A,,5.35,1.06,NA,1.06,,1.33,7.74,7.74,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,12133925,,Rpr pul art unifocal w/o cpb,A,,30.52,9.65,NA,9.65,,7.69,47.86,47.86,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,12233926,,Repr pul art unifocal w/cpb,A,,43.61,12.23,NA,12.23,,11.01,66.85,66.85,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,12333927,,Impltj tot rplcmt hrt sys,A,,47.78,9.42,NA,9.42,,12.06,69.26,69.26,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,12433928,,Rmvl & rplcmt tot hrt sys,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,12533929,,Rmvl rplcmt hrt sys f/trnspl,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,12633930,,Removal of donor heart/lung,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537