No office rate
33988 is for placing the left heart vent; 33989 is for removing it.
On this page
CMS RVU26D · Effective 2026-10-01
33988 Left heart vent Medicare reimbursement rates in Vermont
Reports surgical placement of a left heart vent to decompress the left-sided chambers during cardiac surgery, typically while the patient is on cardiopulmonary bypass. Compare 33988 office and facility rates across CMS payment localities in Vermont.
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 33988 in Vermont?
Vermont 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
$652.13
1 of 1 localities have a supported rate.
Payment area: Vermont
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 33988: Surgical insertion of left heart vent
Reports surgical placement of a left heart vent to decompress the left-sided chambers during cardiac surgery, typically while the patient is on cardiopulmonary bypass.
A left heart vent temporarily drains blood from the left side of the heart to help prevent chamber distention during cardiac surgery. A cardiothoracic surgeon typically places it in the operating room as part of an open cardiac procedure, often while the patient is supported by cardiopulmonary bypass. The operative report should identify the placement and the vent’s role in the procedure.
Report 33988 for the insertion service, not for removal of the vent; distinguish the work from the principal cardiac operation in the documentation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery, co-surgeon, and team-surgery payment each require supporting documentation; assistant payment specifically requires medical necessity.
CMS billing rules for 33988
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU14.63 · 69%
- Practice expense (office) RVU3.16 · 15%
- Malpractice RVU3.49 · 16%
32
Medicare services in 2024 · #5618 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.
33988 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
33990 covers percutaneous insertion of a left heart ventricular assist device, not surgical placement of a vent for decompression.
No office rate
33991 describes percutaneous left heart VAD insertion using arterial and venous access; 33988 reports left heart vent insertion.
Compare 33988 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
Vermont →
Office / nonfacility
Unavailable
Facility
$652.13
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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 33988 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
4,172
- Code
- 33988
- Physician work
- 14.63
- Practice expense
- 3.16
- Malpractice
- 3.49
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.63 | × 1.000 | 14.6300 |
| Practice expense | 3.16 | × 0.990 | 3.1284 |
| Malpractice | 3.49 | × 0.506 | 1.7659 |
| Total RVUs | 19.5243 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$652.13
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.63 | 1 |
| Practice expense | 3.16 | 0.99 |
| Malpractice | 3.49 | 0.506 |
(14.63 × 1 + 3.16 × 0.99 + 3.49 × 0.506) × $33.4009 = $652.13
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.
33988 billing questions
How does insertion differ from removal of a left heart vent?
Use 33988 for placement. Code 33989 describes the removal service.
What documentation supports reporting 33988?
The operative report should establish that the surgeon placed a left heart vent and describe its role in the cardiac procedure.
Is modifier 50 appropriate?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, CMS pays the highest-valued procedure in full and the other procedures at 50%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment require supporting documentation.
Does the code include same-day postoperative care?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
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.
4,16933985,,Ecmo/ecls rmvl ctr cannula,A,,9.64,2.13,NA,2.13,,2.32,14.09,14.09,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17033986,,Ecmo/ecls rmvl ctr cannula,A,,9.75,2.13,NA,2.13,,2.41,14.29,14.29,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17133987,,Artery expos/graft artery,A,,3.94,0.81,NA,0.81,,0.95,5.70,5.70,0,ZZZ,0.00,0.00,0.00,0,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17233988,,Insertion of left heart vent,A,,14.63,3.16,NA,3.16,,3.49,21.28,21.28,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17333989,,Removal of left heart vent,A,,9.26,2.05,NA,2.05,,2.21,13.52,13.52,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17433990,,Insj perq vad l hrt arterial,A,,6.58,1.26,NA,1.26,,1.53,9.37,9.37,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,17533991,,Insj perq vad l hrt artl&ven,A,,8.62,1.77,NA,1.77,,2.06,12.45,12.45,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817