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CPT code 33218: Lead repair, single lead2026 Medicare rate & RVUs

Repair one existing transvenous pacing or defibrillation lead when operative treatment restores its function without implanting a replacement lead.

CMS RVU26DEffective Oct 1, 2026109 payment localities278 Medicare services in 2024

Medicare pays $348.37 for 33218 nationally in a facility.

Medicare rate · 33218

Lead repair, single lead

Office or facility?

Work RVUs
5.67
Total RVUs
10.43
Global days
090

National rate · 2026

$348.37

Facility setting, before claim adjustments.

See every locality for 33218 →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 33218 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 33218 covers

CPT 33218 represents operative repair of one existing transvenous lead used for cardiac pacing or defibrillation. An electrophysiologist or other qualified cardiac surgeon typically performs the procedure in a hospital or other surgical facility when a single lead has a repairable problem, such as damage to its insulation or conductor. The procedure addresses the existing lead; it is distinct from placing a new lead or repositioning a lead that remains intact.

Report one unit for repair of a single lead, supported by the operative report identifying the lead and the repair performed. Distinguish repair from insertion, replacement, and repositioning based on the work documented. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. If 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% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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 33218 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

33218 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$314.77
AlaskaUnavailable$430.56
ArizonaUnavailable$338.42
ArkansasUnavailable$310.67
Atlanta, GAUnavailable$359.70
Austin, TXUnavailable$350.33
Bakersfield, CAUnavailable$345.60
Baltimore area, MDUnavailable$370.29
Beaumont, TXUnavailable$334.91
Brazoria, TXUnavailable$339.08

33218 rates by state

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

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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
33218 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 33218 rate is calculated

Each of 33218’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 · 33218

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.67

5.67 RVUs× 1.000 GPCI

Practice expense3.43

3.43 RVUs× 1.000 GPCI

Malpractice1.33

1.33 RVUs× 1.000 GPCI

Adjusted RVUs

10.4300

Conversion factor

$33.4009

Medicare rate

$348.37

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

Payment rules and modifiers for 33218

33218 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33218

Lead repair, single lead

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 · 33218

Lead repair, single lead

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

33218 without 51 · national facility

$348.37

Lead repair, single lead

33218-51 · Second procedure: 50%

$174.19

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

33218 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 33218

    Lead repair, single lead5.67 wRVU

    Not priced

  • 33220

    Lead repair, two leads5.75 wRVU

    Not priced

  • 33215

    Lead repositioning, pacing-defibrillator lead4.8 wRVU

    Not priced

  • 33216

    ICD lead insertion, single transvenous lead5.48 wRVU

    Not priced

How to choose

33220Lead repairTwo leads
33218 is for repair of one lead; 33220 is for repair of two. Use the number repaired, as documented in the operative report.
33215Lead repositioningPacing-defibrillator lead
33215 describes repositioning an existing lead. Choose 33218 when the work repairs the lead instead of changing its position.
33216ICD lead insertionSingle transvenous lead
33216 describes insertion of one pacing-defibrillation electrode. Choose 33218 for repair of a single existing lead, not placement of a new one.

Codes related to 33218

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

Codes related to 33218
CodeHow it relatesNational office range
Same family
33220Lead repair, two leadsRelated repair code for two pacing-defibrillation leads.No office rate
Used instead
33215Lead repositioning, pacing-defibrillator leadUsed to reposition an existing pacing-defibrillation lead rather than repair it.No office rate
33216ICD lead insertion, single transvenous leadInsertion of one pacing-defibrillation electrode, rather than repair of an existing lead.No office rate
33217Lead insertion, two permanent-system electrodesInsertion of two pacing-defibrillation electrodes, rather than repair of an existing lead.No office rate

33218 billing questions

When should 33218 be chosen instead of 33215?

Use 33218 when the surgeon repairs one existing lead. Use 33215 when the lead is repositioned rather than repaired.

How does 33218 differ from 33216?

33218 describes repair of an existing single lead. Code 33216 describes insertion of one pacing-defibrillation electrode.

When is 33220 reported instead?

33220 is the related code for repair of two leads. The operative documentation should support the number of leads repaired.

What documentation supports reporting 33218?

The operative report should identify the existing lead, describe the repair performed, and establish that one lead was repaired rather than repositioned or replaced.

Can modifier 50 or an assistant-at-surgery claim be used?

No. CMS identifies bilateral adjustment as inappropriate for this code and bars payment for an assistant at surgery.

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 33218PPRRVU2026_Oct_nonQPP.csv, line 3,847 (RVU26D)

Open CMS sourceHow we calculate rates

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