No office rate
33990 reports percutaneous placement of a left-heart VAD by an arterial approach. This code is for repositioning an existing device.
On this page
CMS RVU26D · Effective 2026-10-01
33993 VAD repositioning Medicare reimbursement rates in Virginia
Reports image-guided catheter repositioning of an existing percutaneous right- or left-heart ventricular assist device when its position must be adjusted to maintain support. Compare 33993 office and facility rates across CMS payment localities in Virginia.
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 33993 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$136.22–$153.85
2 of 2 localities have a supported rate.
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 procedures
About 33993: Percutaneous ventricular assist device repositioning
Reports image-guided catheter repositioning of an existing percutaneous right- or left-heart ventricular assist device when its position must be adjusted to maintain support.
This service adjusts the position of an already placed percutaneous ventricular assist device in the right or left heart, using imaging guidance to direct and confirm the repositioning. It is typically performed by an interventional cardiologist in a catheterization laboratory or another setting where temporary mechanical circulatory support is managed. The work is distinct from placing a new device or removing one that is no longer needed.
Report the code when the record supports a separate repositioning service, including the device involved, why its position required adjustment, and how imaging was used to guide the work. Imaging guidance and its associated supervision and interpretation are included. The service has 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 33993
- 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 RVU3.02 · 71%
- Practice expense (office) RVU0.66 · 15%
- Malpractice RVU0.58 · 14%
965
Medicare services in 2024 · #3002 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.
33993 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
33991 reports percutaneous left-heart VAD placement using arterial and venous approaches; it is not the code for subsequent position adjustment.
No office rate
33995 reports percutaneous right-heart VAD placement. Choose this code when an existing percutaneous right- or left-heart VAD is repositioned instead.
No office rate
33992 reports percutaneous removal of a left-heart VAD. Repositioning applies when the device remains in place and its position is adjusted.
Compare 33993 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$153.85
Virginia →
Office / nonfacility
Unavailable
Facility
$136.22
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33993 billing questions
When should this code be used instead of an insertion code?
Use it for adjusting the position of a percutaneous ventricular assist device that is already in place. Report an insertion code when the service places the device rather than repositioning it.
Is imaging guidance separately reported?
No. Imaging guidance, including the associated supervision and interpretation, is part of the repositioning service.
Can modifier 50 be used for repositioning on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How does the multiple-procedure reduction affect payment?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.
Can an assistant-at-surgery be reported?
Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted.
What documentation supports reporting repositioning?
Document the device and heart side, the reason its position needed adjustment, the repositioning performed, and the imaging used to guide the work.
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.
4,17433990,,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
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