No office rate
Use 33978 for removal of an extracorporeal device supporting one ventricle; use 33977 when the device supported both ventricles.
On this page
CMS RVU26D · Effective 2026-10-01
33978 VAD removal Medicare reimbursement rates in Rhode Island
Reports surgical removal of an extracorporeal ventricular assist device supporting one ventricle, such as after temporary mechanical circulatory support is no longer needed. Compare 33978 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 33978 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
$1238.75
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 33978: Single-ventricle extracorporeal VAD removal
Reports surgical removal of an extracorporeal ventricular assist device supporting one ventricle, such as after temporary mechanical circulatory support is no longer needed.
CPT 33978 describes removal of an extracorporeal ventricular assist device that has supported a single ventricle. A cardiac surgeon may perform the procedure when a patient’s heart function has recovered enough to discontinue temporary mechanical support. The operation takes place in a surgical setting and addresses removal of the device used for ventricular support, rather than removal of an implantable intracorporeal pump or an intra-aortic balloon device.
Choose this code when the operative record identifies removal of an extracorporeal device supporting one ventricle. Documentation should establish the device type, the supported ventricle or ventricles, and that removal was performed. When other procedures occur during the same session, CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full and the others at 50%. CMS pricing treats this service as bilateral; modifier 50 does not increase payment.
CMS billing rules for 33978
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU24.38 · 66%
- Practice expense (office) RVU6.81 · 18%
- Malpractice RVU5.84 · 16%
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.
33978 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
33978 is for an extracorporeal device. 33980 is for removal of an implantable intracorporeal ventricular assist device.
No office rate
33976 reports insertion of an extracorporeal ventricular assist device supporting one ventricle; 33978 reports removal of that device type.
Compare 33978 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
$1238.75
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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 33978 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
4,162
- Code
- 33978
- Physician work
- 24.38
- Practice expense
- 6.81
- Malpractice
- 5.84
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.38 | × 1.019 | 24.8432 |
| Practice expense | 6.81 | × 1.033 | 7.0347 |
| Malpractice | 5.84 | × 0.892 | 5.2093 |
| Total RVUs | 37.0872 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$1238.75
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 24.38 | 1.019 |
| Practice expense | 6.81 | 1.033 |
| Malpractice | 5.84 | 0.892 |
(24.38 × 1.019 + 6.81 × 1.033 + 5.84 × 0.892) × $33.4009 = $1238.75
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.
33978 billing questions
How does 33978 differ from 33977?
33978 is for removal of an extracorporeal ventricular assist device supporting one ventricle. 33977 is the corresponding removal code for a device supporting both ventricles.
Is this the code for removing an implanted VAD?
No. 33978 covers an extracorporeal device; 33980 describes removal of an implantable intracorporeal ventricular assist device.
Should modifier 50 be added?
CMS pricing already treats 33978 as bilateral, and modifier 50 does not increase payment.
How does the multiple procedure reduction affect 33978?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. The reduction depends on how 33978 ranks among the procedures performed.
What documentation supports reporting 33978?
The operative report should identify the extracorporeal ventricular assist device, confirm that it supported one ventricle, and describe its removal.
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.
4,15933975,,Implant ventricular device,A,,24.38,4.87,NA,4.87,,6.02,35.27,35.27,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,16033976,,Implant ventricular device,A,,29.98,6.15,NA,6.15,,7.20,43.33,43.33,0,XXX,0.00,0.00,0.00,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,16133977,,Remove ventricular device,A,,20.34,5.71,NA,5.71,,4.95,31.00,31.00,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,16233978,,Remove ventricular device,A,,24.38,6.81,NA,6.81,,5.84,37.03,37.03,0,XXX,0.00,0.00,0.00,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,16333979,,Insert intracorporeal device,A,,36.56,7.38,NA,7.38,,9.01,52.95,52.95,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,16433980,,Remove intracorporeal device,A,,32.66,8.26,NA,8.26,,8.07,48.99,48.99,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,16533981,,Replace vad pump ext,A,,15.71,3.23,NA,3.23,,3.75,22.69,22.69,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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