FeeBase
Log inGet started
Menu

CPT code 33213: Pacemaker generator, existing dual leads2026 Medicare rate & RVUs

Reports placement of a pacemaker pulse generator connected to an existing dual-lead system when the leads are retained.

CMS RVU26DEffective Oct 1, 2026109 payment localities796 Medicare services in 2024

Medicare pays $303.61 for 33213 nationally in a facility.

Medicare rate · 33213

Pacemaker generator, existing dual leads

Office or facility?

Work RVUs
5.15
Total RVUs
9.09
Global days
090

National rate · 2026

$303.61

Facility setting, before claim adjustments.

See every locality for 33213 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 33213 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 33213 covers

This service places a pacemaker pulse generator and connects it to two leads already in place, without inserting new leads as part of the reported procedure. It is typically performed by a cardiologist or electrophysiologist in a hospital operating room or electrophysiology setting. The operative record should make clear that the generator was inserted and that the existing dual leads were used.

Report the dual-lead generator service rather than the single-lead or multiple-lead generator code, and distinguish it from a procedure that removes and replaces an existing generator. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures subject to the reduction occur in the same session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is barred by statutory restriction; 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 33213 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

33213 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$274.57
AlaskaUnavailable$377.23
ArizonaUnavailable$294.93
ArkansasUnavailable$271.04
Atlanta, GAUnavailable$313.77
Austin, TXUnavailable$304.58
Bakersfield, CAUnavailable$299.67
Baltimore area, MDUnavailable$322.66
Beaumont, TXUnavailable$292.54
Brazoria, TXUnavailable$295.21

33213 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
33213 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 33213 rate is calculated

Each of 33213’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 · 33213

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.15

5.15 RVUs× 1.000 GPCI

Practice expense2.72

2.72 RVUs× 1.000 GPCI

Malpractice1.22

1.22 RVUs× 1.000 GPCI

Adjusted RVUs

9.0900

Conversion factor

$33.4009

Medicare rate

$303.61

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 33213

33213 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33213

Pacemaker generator, existing dual leads

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33213

Pacemaker generator, existing dual leads

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33213 without 51 · national facility

$303.61

Pacemaker generator, existing dual leads

33213-51 · Second procedure: 50%

$151.81

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%).

When to use modifier 51

33213 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 33213

    Pacemaker generator, existing dual leads5.15 wRVU

    Not priced

  • 33212

    Pacemaker generator, existing single lead4.88 wRVU

    Not priced

  • 33221

    Pacemaker generator, existing multiple leads5.41 wRVU

    Not priced

  • 33228

    Pacemaker generator exchange, dual-lead system5.38 wRVU

    Not priced

  • 33208

    Pacemaker implant, atrial and ventricular leads8.31 wRVU

    Not priced

How to choose

33212Pacemaker generatorExisting single lead
33212 is for generator insertion with an existing single lead. Use 33213 when the existing system has dual leads.
33221Pacemaker generatorExisting multiple leads
33221 is for generator insertion with existing multiple leads. This code is for an existing dual-lead system.
33228Pacemaker generator exchangeDual-lead system
33228 includes removal and replacement of the existing dual-lead system's generator. This code describes generator insertion using existing dual leads.
33208Pacemaker implantAtrial and ventricular leads
33208 describes insertion of a new dual-chamber pacemaker system with leads. This code is for generator placement using dual leads already in place.

Codes related to 33213

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 33213
CodeHow it relatesNational office range
Same family
33212Pacemaker generator, existing single leadGenerator-only insertion with an existing single-lead system.No office rate
33221Pacemaker generator, existing multiple leadsGenerator-only insertion with existing multiple leads.No office rate
Used instead
33228Pacemaker generator exchange, dual-lead systemRemoval and replacement of a generator in a dual-lead system.No office rate
33208Pacemaker implant, atrial and ventricular leadsInsertion of a new dual-chamber pacemaker system with transvenous leads.No office rate

33213 billing questions

How does this differ from 33212 or 33221?

Choose 33213 when the generator is connected to an existing dual-lead system. Code 33212 is for an existing single lead, while 33221 is for existing multiple leads.

When is 33228 used instead?

33228 describes removal and replacement of a generator in a dual-lead system. This code describes insertion of a generator only, using existing dual leads.

Can this code be reported when new leads are inserted?

This code represents generator placement with existing dual leads. When a new dual-chamber system, including its leads, is inserted, consider 33208 instead.

What documentation supports reporting this code?

The operative note should identify generator insertion, the two existing leads used, and the work performed to connect the generator to them.

How does the global period affect follow-up billing?

The 90-day global includes the day-before preoperative visit and related postoperative care through day 90. CMS also applies the standard multiple procedure reduction when qualifying procedures occur in the same session.

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
RVUs for 33213PPRRVU2026_Oct_nonQPP.csv, line 3,842 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 33213 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 33213 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist