No office rate
Use 33982 for replacement of an intracorporeal VAD pump without bypass. Code 33981 is for an extracorporeal VAD pump.
On this page
CMS RVU26D · Effective 2026-10-01
33981 VAD pump replacement Medicare reimbursement rates in Wyoming
Reports replacement of the pump in an extracorporeal ventricular assist device, whether the device supports one ventricle or both. Compare 33981 office and facility rates across CMS payment localities in Wyoming.
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 33981 in Wyoming?
Wyoming 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
$725.30
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 33981: Extracorporeal VAD pump replacement
Reports replacement of the pump in an extracorporeal ventricular assist device, whether the device supports one ventricle or both.
This service replaces the external pump component of an extracorporeal ventricular assist device (VAD) used to support circulation when a patient’s heart cannot provide adequate output. It is generally performed by a cardiac surgeon in an operating room or comparable surgical setting. The code distinguishes an extracorporeal pump exchange from replacement of an implanted intracorporeal VAD pump.
Report the code when the operative record supports replacement of the extracorporeal VAD pump, not initial device placement or device removal alone. Documentation should identify the VAD as extracorporeal, describe the pump replacement, and establish whether the device supports one or both ventricles. When multiple procedures are performed in the same session, CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full, and other procedures are paid at 50%.
CMS billing rules for 33981
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Where the value comes from
- Work RVU15.71 · 69%
- Practice expense (office) RVU3.23 · 14%
- Malpractice RVU3.75 · 17%
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.
33981 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Use 33983 for replacement of an intracorporeal VAD pump with bypass. Code 33981 describes an extracorporeal pump replacement.
No office rate
Code 33975 reports initial placement of an extracorporeal VAD; 33981 reports replacement of its pump.
No office rate
Code 33977 is for removal of an extracorporeal VAD. It does not describe replacement of the pump.
Compare 33981 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$725.30
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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 33981 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,165
- Code
- 33981
- Physician work
- 15.71
- Practice expense
- 3.23
- Malpractice
- 3.75
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.71 | × 1.000 | 15.7100 |
| Practice expense | 3.23 | × 1.000 | 3.2300 |
| Malpractice | 3.75 | × 0.740 | 2.7750 |
| Total RVUs | 21.7150 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$725.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.71 | 1 |
| Practice expense | 3.23 | 1 |
| Malpractice | 3.75 | 0.74 |
(15.71 × 1 + 3.23 × 1 + 3.75 × 0.74) × $33.4009 = $725.30
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.
33981 billing questions
How does this differ from 33982 or 33983?
Code 33981 is for replacement of an extracorporeal VAD pump. Codes 33982 and 33983 concern replacement of an intracorporeal VAD pump; the distinction between those codes is whether bypass is used.
Is this code for initial VAD placement?
No. It describes replacement of the pump in an existing extracorporeal VAD, rather than initial placement of an extracorporeal VAD.
Can this be reported for VAD removal alone?
No. Removal alone is a different service; the operative documentation must support pump replacement.
How are multiple procedures paid in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50% when multiple procedures are performed in the same session.
What should the operative report establish?
It should identify the device as extracorporeal and document that its pump was replaced. It should also clarify whether the VAD supports one ventricle or both.
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.
4,16233978,,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
4,16633982,,Replace vad intra w/o bp,A,,36.91,7.57,NA,7.57,,8.85,53.33,53.33,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,16733983,,Replace vad intra w/bp,A,,43.43,8.92,NA,8.92,,10.43,62.78,62.78,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,16833984,,Ecmo/ecls rmvl prph cannula,A,,5.32,1.11,NA,1.11,,1.31,7.74,7.74,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,