Billing code 33967: Balloon pump insertionMedicare rate & RVUs in Virginia
Reports percutaneous placement of an intra-aortic balloon pump for temporary circulatory support, such as in cardiogenic shock or selected high-risk cardiac procedures.
CMS doesn’t publish an office rate for 33967 in Virginia.
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 33967 covers
This service places an intra-aortic balloon catheter through percutaneous arterial access, commonly in a hospital catheterization laboratory or operating room. The balloon sits in the aorta and provides counterpulsation to support circulation. Cardiologists and cardiothoracic surgeons commonly perform the insertion for patients needing temporary hemodynamic support, including some patients with cardiogenic shock or undergoing high-risk cardiac procedures.
Report 33967 for the percutaneous insertion itself, not for removal or insertion by a nonpercutaneous approach. The procedure note should establish the indication, access technique, and device placement. The 0-day global period includes same-day preoperative and postoperative care. When other procedures are performed 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. Assistant-at-surgery payment requires documentation of medical necessity; 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 33967 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $242.88 |
| Virginia | Unavailable | $213.56 |
How the 33967 rate is calculated
Each of 33967’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 · 33967
RVUs × geographic indexes × conversion factor
Work4.72
4.72 RVUs× 1.000 GPCI
Practice expense0.92
0.92 RVUs× 1.000 GPCI
Malpractice1.09
1.09 RVUs× 1.000 GPCI
Adjusted RVUs
6.7300
Conversion factor
$33.4009
Medicare rate
$224.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33967
The CMS indicators that decide how 33967 is paid alongside other services.
CMS payment indicators · 33967
Balloon pump insertion
| 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) | 0 | Not paid without supporting documentation. |
| 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
33967 without 51 · national facility
$224.79
Balloon pump insertion
33967-51 · Second procedure: 50%
$112.40
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%).
33967 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33968Balloon removal
- 33967 reports percutaneous insertion; 33968 reports percutaneous removal of the intra-aortic balloon pump.
- 33970Aortic assist device
- Both describe intra-aortic balloon pump insertion, but 33970 is for a nonpercutaneous approach.
- 33990VAD insertion
- 33990 describes percutaneous insertion of a ventricular assist device, not placement of an intra-aortic balloon pump.
33967 billing questions
How does 33967 differ from 33970?
33967 is for percutaneous balloon-pump insertion. Use 33970 for insertion by a nonpercutaneous approach.
Is removal included in 33967?
No. Code 33967 reports insertion; 33968 is the percutaneous removal code.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the global period.
Can modifier 50 be reported?
No. Bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
When is assistant-at-surgery payment allowed?
It is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.
How does 33967 differ from percutaneous ventricular assist device insertion?
33967 is for an intra-aortic balloon pump. Codes such as 33990 and 33991 describe percutaneous ventricular assist device insertion, a different form of circulatory support.
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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