No office rate
Choose 33997 for percutaneous right-heart VAD removal; 33992 is for percutaneous left-heart VAD removal.
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CMS RVU26D · Effective 2026-10-01
33997 VAD removal Medicare reimbursement rates in Tennessee
Removal of a percutaneously placed right-heart ventricular assist device, typically after temporary mechanical support for acute right ventricular failure is no longer needed. Compare 33997 office and facility rates across CMS payment localities in Tennessee.
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 33997 in Tennessee?
Tennessee 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
$127.49
1 of 1 localities have a supported rate.
Payment area: Tennessee
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.
Cardiovascular surgery
About 33997: Percutaneous right-heart VAD removal
Removal of a percutaneously placed right-heart ventricular assist device, typically after temporary mechanical support for acute right ventricular failure is no longer needed.
This service removes a temporary ventricular assist device that provides percutaneous support to the right side of the heart, generally through venous access. It is typically performed by a cardiac surgeon or interventional cardiologist in a hospital setting, such as a cardiac catheterization laboratory or intensive care unit, when the patient has recovered enough to stop mechanical support or the device must be removed for another clinical reason.
Report the removal rather than device insertion or repositioning, and document the device, its percutaneous right-heart configuration, the removal, and the reason support is ending. The CMS global period is 0 days, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this single right-heart device service. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 33997
- 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 RVU2.93 · 70%
- Practice expense (office) RVU0.58 · 14%
- Malpractice RVU0.67 · 16%
127
Medicare services in 2024 · #4687 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.
33997 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
33993 represents repositioning a percutaneous right- or left-heart VAD. Report 33997 when the right-heart device is removed.
No office rate
33995 is for placing percutaneous right-heart VAD support; 33997 is for taking that type of device out.
No office rate
33980 concerns removal of an intracorporeal VAD. Use 33997 for removal of a percutaneous right-heart device.
Compare 33997 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$127.49
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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 33997 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
4,179
- Code
- 33997
- Physician work
- 2.93
- Practice expense
- 0.58
- Malpractice
- 0.67
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.93 | × 1.000 | 2.9300 |
| Practice expense | 0.58 | × 0.909 | 0.5272 |
| Malpractice | 0.67 | × 0.537 | 0.3598 |
| Total RVUs | 3.8170 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$127.49
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1 |
| Practice expense | 0.58 | 0.909 |
| Malpractice | 0.67 | 0.537 |
(2.93 × 1 + 0.58 × 0.909 + 0.67 × 0.537) × $33.4009 = $127.49
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.
33997 billing questions
How is this different from 33992?
33997 is for removal of a percutaneous right-heart VAD. Code 33992 is the corresponding removal code for a percutaneous left-heart VAD.
Should removal be reported with repositioning?
Use 33997 when the device is removed. Code 33993 describes repositioning a percutaneous right- or left-heart VAD, not removal.
What documentation supports 33997?
Document the percutaneous right-heart device, its removal, and the clinical reason it was taken out. The record should distinguish removal from repositioning or removal of a different VAD configuration.
Can an assistant surgeon be reported?
CMS permits assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
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.
Is modifier 50 appropriate?
No. The service concerns a single right-heart device, so the descriptor and anatomy make modifier 50 inappropriate.
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.
4,17633992,,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
4,18033999,,Unlisted px cardiac surgery,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,18134001,,Removal of artery clot,A,,17.43,3.11,NA,3.11,,4.46,25.00,25.00,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,18234051,,Removal of artery clot,A,,16.57,8.37,NA,8.37,,3.96,28.90,28.90,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780