CPT code 33206: Pacemaker implant, atrial pacing system2026 Medicare rate & RVUs in South Dakota
Reports implantation of a permanent transvenous pacemaker configured for atrial pacing, commonly for selected patients with sinus node dysfunction and preserved AV conduction.
In South Dakota, Medicare pays $366.00 for 33206 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33206 nationwide
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 11 sections
What 33206 covers
A cardiologist or electrophysiologist places a transvenous pacing lead in the atrium and connects it to a pulse generator, usually positioned in a pocket beneath the skin of the chest. This service is used for a permanent atrial pacing system, including selected patients with sinus node dysfunction and preserved atrioventricular conduction. Implantation commonly takes place in a hospital electrophysiology or cardiac catheterization lab.
Select this code when the implanted permanent system provides atrial pacing; use the chamber configuration documented in the operative report to distinguish it from ventricular-only or dual-chamber implantation. Documentation should identify the permanent system, lead placement, and generator implantation. The code represents the implant service, not a generator-only procedure or a charge per lead. It has a 90-day global period that includes the day-before preoperative visit and related postoperative care. When multiple procedures occur 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 not appropriate for this implant. Assistant-at-surgery payment is statutorily restricted; co-surgeons are permitted, but team surgery is not.
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.
How South Dakota compares for 33206
Across 109 of 109 payment localities, the facility rate for 33206 runs from $359.41 in Nebraska to $501.43 in Alaska. South Dakota pays $366.00. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$366.00
- Los Angeles, CA · California$414.47+$48.47
- Washington, DC area · District of Columbia$441.36+$75.36
- Miami, FL · Florida$490.12+$124.12
- Chicago, IL · Illinois$474.85+$108.85
- Manhattan, NY · New York$467.60+$101.60
- Alaska · Alaska$501.43+$135.43
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $364.11 |
| ArkansasArkansas | — | $359.49 |
| ArizonaArizona | — | $390.73 |
| Bakersfield, CACalifornia | — | $396.34 |
| Chico, CACalifornia | — | $391.90 |
| El Centro, CACalifornia | — | $392.17 |
| Fresno, CACalifornia | — | $391.90 |
| Hanford, CACalifornia | — | $391.90 |
| Madera, CACalifornia | — | $391.90 |
| Merced, CACalifornia | — | $391.90 |
| Modesto, CACalifornia | — | $391.90 |
| Napa, CACalifornia | — | $426.65 |
| Oxnard, CACalifornia | — | $409.10 |
| Redding, CACalifornia | — | $391.90 |
| Rest of CaliforniaCalifornia | — | $391.90 |
| Riverside, CACalifornia | — | $409.39 |
| Sacramento, CACalifornia | — | $404.04 |
| Salinas, CACalifornia | — | $402.41 |
| San Diego, CACalifornia | — | $406.77 |
| Marin County, CACalifornia | — | $442.02 |
| San Francisco, CACalifornia | — | $440.17 |
| San Benito County, CACalifornia | — | $453.39 |
| Santa Clara County, CACalifornia | — | $445.82 |
| San Luis Obispo, CACalifornia | — | $396.85 |
| Santa Cruz, CACalifornia | — | $406.54 |
| Santa Maria, CACalifornia | — | $402.52 |
| Santa Rosa, CACalifornia | — | $410.13 |
| Stockton, CACalifornia | — | $391.90 |
| Vallejo, CACalifornia | — | $423.98 |
| Visalia, CACalifornia | — | $391.90 |
| Yuba City, CACalifornia | — | $391.90 |
| ColoradoColorado | — | $400.39 |
| ConnecticutConnecticut | — | $427.10 |
| DelawareDelaware | — | $396.43 |
| Fort Lauderdale, FLFlorida | — | $447.64 |
| Rest of FloridaFlorida | — | $424.46 |
| Atlanta, GAGeorgia | — | $415.63 |
| Rest of GeorgiaGeorgia | — | $400.15 |
| Hawaii, Guam, HIHawaii | — | $395.01 |
| IowaIowa | — | $359.52 |
| IdahoIdaho | — | $364.24 |
| East St. Louis, ILIllinois | — | $448.13 |
| Rest of IllinoisIllinois | — | $422.77 |
| Suburban Chicago, ILIllinois | — | $448.92 |
| IndianaIndiana | — | $365.75 |
| KansasKansas | — | $364.08 |
| KentuckyKentucky | — | $384.73 |
| New Orleans, LALouisiana | — | $402.75 |
| Rest of LouisianaLouisiana | — | $386.61 |
| Metropolitan Boston, MAMassachusetts | — | $428.04 |
| Rest of MassachusettsMassachusetts | — | $400.92 |
| Baltimore area, MDMaryland | — | $427.18 |
| Rest of MarylandMaryland | — | $401.39 |
| Rest of MaineMaine | — | $372.35 |
| Southern Maine, MEMaine | — | $381.02 |
| Detroit, MIMichigan | — | $435.46 |
| Rest of MichiganMichigan | — | $399.14 |
| MinnesotaMinnesota | — | $367.16 |
| Metropolitan Kansas City, MOMissouri | — | $393.87 |
| Metropolitan St. Louis, MOMissouri | — | $396.72 |
| Rest of MissouriMissouri | — | $384.83 |
| MississippiMississippi | — | $371.92 |
| MontanaMontana | — | $402.04 |
| North CarolinaNorth Carolina | — | $374.77 |
| North DakotaNorth Dakota | — | $369.81 |
| NebraskaNebraska | — | $359.41 |
| New HampshireNew Hampshire | — | $400.07 |
| Northern New JerseyNew Jersey | — | $438.93 |
| Rest of New JerseyNew Jersey | — | $427.33 |
| New MexicoNew Mexico | — | $403.53 |
| NevadaNevada | — | $393.17 |
| NYC suburbs and Long Island, NYNew York | — | $485.46 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $434.99 |
| Queens, NYNew York | — | $462.06 |
| Rest of New YorkNew York | — | $380.22 |
| OhioOhio | — | $392.56 |
| OklahomaOklahoma | — | $377.68 |
| Portland, OROregon | — | $404.72 |
| Rest of OregonOregon | — | $385.52 |
| Metropolitan Philadelphia, PAPennsylvania | — | $421.56 |
| Rest of PennsylvaniaPennsylvania | — | $389.70 |
| Puerto RicoPuerto Rico | — | $402.60 |
| Rhode IslandRhode Island | — | $404.49 |
| South CarolinaSouth Carolina | — | $385.22 |
| TennesseeTennessee | — | $366.45 |
| Austin, TXTexas | — | $403.09 |
| Beaumont, TXTexas | — | $387.91 |
| Brazoria, TXTexas | — | $390.99 |
| Dallas, TXTexas | — | $396.05 |
| Fort Worth, TXTexas | — | $395.60 |
| Galveston, TXTexas | — | $393.84 |
| Houston, TXTexas | — | $423.67 |
| Rest of TexasTexas | — | $390.99 |
| UtahUtah | — | $389.68 |
| VirginiaVirginia | — | $384.18 |
| Virgin Islands, VIUnited States Virgin Islands | — | $402.60 |
| VermontVermont | — | $374.10 |
| Rest of WashingtonWashington | — | $398.26 |
| King County, WAWashington | — | $429.97 |
| WisconsinWisconsin | — | $359.63 |
| West VirginiaWest Virginia | — | $410.52 |
| WyomingWyoming | — | $387.99 |
33206 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 33206 rate is calculated
Each of 33206’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 · 33206
RVUs × geographic indexes × conversion factor
Work6.96
6.96 RVUs× 1.000 GPCI
Practice expense3.45
3.45 RVUs× 1.000 GPCI
Malpractice1.63
1.63 RVUs× 1.000 GPCI
Adjusted RVUs
12.0400
Conversion factor
$33.4009
Medicare rate
$402.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,835
- Code
- 33206
- Physician work
- 6.96
- Practice expense
- 3.45
- Malpractice
- 1.63
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.96 | × 1.000 | 6.9600 |
| Practice expense | 3.45 | × 1.000 | 3.4500 |
| Malpractice | 1.63 | × 0.336 | 0.5477 |
| Total RVUs | 10.9577 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, South Dakota$366.00
Facility: (6.96 × 1 + 3.45 × 1 + 1.63 × 0.336) × $33.4009 = $366.00
Payment rules and modifiers for 33206
33206 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33206
Pacemaker implant, atrial pacing system
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33206
Pacemaker implant, atrial pacing system
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33206 without 51 · national facility
$402.15
Pacemaker implant, atrial pacing system
33206-51 · Second procedure: 50%
$201.08
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%).
How 33206 has changed in South Dakota
33206 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $366.00 | RVU26D |
| 2026-07-01 | Not available in this setting | $366.00 | RVU26C |
| 2026-04-01 | Not available in this setting | $366.00 | RVU26B |
| 2026-01-01 | Not available in this setting | $366.00 | RVU26A |
| 2025-10-01 | Not available in this setting | $403.72 | RVU25D |
| 2025-07-01 | Not available in this setting | $403.72 | RVU25C |
| 2025-04-01 | Not available in this setting | $403.72 | RVU25B |
| 2025-01-01 | Not available in this setting | $403.72 | RVU25A |
| 2024-10-01 | Not available in this setting | $413.26 | RVU24D |
| 2024-07-01 | Not available in this setting | $413.26 | RVU24C |
| 2024-04-01 | Not available in this setting | $413.26 | RVU24B |
| 2024-03-09 | Not available in this setting | $413.26 | RVU24AR |
| 2024-01-01 | Not available in this setting | $406.52 | RVU24A |
| 2023-10-01 | Not available in this setting | $422.62 | RVU23D |
| 2023-07-01 | Not available in this setting | $422.62 | RVU23C |
| 2023-04-01 | Not available in this setting | $422.62 | RVU23B |
| 2023-01-01 | Not available in this setting | $422.62 | RVU23A |
| 2022-10-01 | Not available in this setting | $430.12 | RVU22D |
| 2022-07-01 | Not available in this setting | $430.12 | RVU22C |
| 2022-04-01 | Not available in this setting | $430.12 | RVU22B |
| 2022-01-01 | Not available in this setting | $430.12 | RVU22A |
| 2021-10-01 | Not available in this setting | $431.69 | RVU21D |
| 2021-07-01 | Not available in this setting | $431.69 | RVU21C |
| 2021-04-01 | Not available in this setting | $431.69 | RVU21B |
| 2021-01-01 | Not available in this setting | $431.69 | RVU21A |
| 2020-10-01 | Not available in this setting | $439.62 | RVU20D |
| 2020-07-01 | Not available in this setting | $439.62 | RVU20C |
| 2020-04-01 | Not available in this setting | $439.62 | RVU20B |
| 2020-01-01 | Not available in this setting | $439.62 | RVU20A |
| 2019-10-01 | Not available in this setting | $437.80 | RVU19D |
| 2019-07-01 | Not available in this setting | $437.80 | RVU19C |
| 2019-04-01 | Not available in this setting | $437.80 | RVU19B |
| 2019-01-01 | Not available in this setting | $437.80 | RVU19A |
| 2018-10-01 | Not available in this setting | $436.68 | RVU18D |
| 2018-07-01 | Not available in this setting | $436.68 | RVU18C |
| 2018-04-01 | Not available in this setting | $436.68 | RVU18B |
| 2018-01-01 | Not available in this setting | $436.68 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $434.03 | RVU17D |
| 2017-07-01 | Not available in this setting | $434.03 | RVU17C |
| 2017-04-01 | Not available in this setting | $434.03 | RVU17B |
| 2017-01-01 | Not available in this setting | $434.03 | RVU17A |
| 2016-10-01 | Not available in this setting | $442.76 | RVU16D |
| 2016-07-01 | Not available in this setting | $442.76 | RVU16C |
| 2016-04-01 | Not available in this setting | $442.76 | RVU16B |
| 2016-01-01 | Not available in this setting | $442.76 | RVU16A |
| 2015-10-01 | Not available in this setting | $444.57 | RVU15D |
| 2015-07-01 | Not available in this setting | $444.57 | RVU15C |
| 2015-04-01 | Not available in this setting | $442.36 | RVU15B |
| 2015-01-01 | Not available in this setting | $442.36 | RVU15A |
| 2014-10-01 | Not available in this setting | $439.36 | RVU14D |
| 2014-07-01 | Not available in this setting | $439.36 | RVU14C |
| 2014-04-01 | Not available in this setting | $439.36 | RVU14B |
| 2014-01-01 | Not available in this setting | $439.36 | RVU14A |
| 2013-10-01 | Not available in this setting | $428.00 | RVU13D |
| 2013-07-01 | Not available in this setting | $428.00 | RVU13C |
| 2013-04-01 | Not available in this setting | $428.00 | RVU13B |
| 2013-01-01 | Not available in this setting | $428.00 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
33206 billing questions
How does 33206 differ from 33207 and 33208?
33206 is for a permanent system configured for atrial pacing. Use 33207 for ventricular-only pacing and 33208 for a system pacing both the atrium and ventricle.
Does 33206 include the pulse generator?
Yes. It represents implantation of the permanent atrial pacing system, including the transvenous lead and pulse generator; it is not a generator-only code.
Should the code be reported once per lead?
No. Report the implant service once for the procedure, not separately for each electrode.
Can an assistant surgeon be paid for 33206?
CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons are permitted, while team surgery is not.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is 33210 a better comparison?
33210 describes temporary transvenous pacing catheter placement. It is distinct from implantation of a permanent atrial pacing system.
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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