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

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

CMS RVU26DEffective Oct 1, 20263 payment localities278 Medicare services in 2024

CMS doesn’t publish an office rate for 33218 in Florida.

—Office (non-facility)
$365.68–$420.99Hospital or facility

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 9 sections
  1. Rate in Florida
  2. What 33218 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. 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 in Florida

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

33218 office and facility rates by payment locality
Payment localityOfficeFacility
Fort Lauderdale, FLUnavailable$385.75
Miami, FLUnavailable$420.99
Rest of FloridaUnavailable$365.68

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.

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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