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CPT code 33226: LV lead repositioning, previously placed transvenous lead2026 Medicare rate & RVUs

Report 33226 when a previously implanted transvenous left ventricular pacing lead is repositioned to correct its location in a cardiac resynchronization system.

CMS RVU26DEffective Oct 1, 2026109 payment localities126 Medicare services in 2024

Medicare pays $423.19 for 33226 nationally in a facility.

Medicare rate · 33226

LV lead repositioning, previously placed transvenous lead

Office or facility?

Work RVUs
8.46
Total RVUs
12.67
Global days
000

National rate · 2026

$423.19

Facility setting, before claim adjustments.

See every locality for 33226 →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 33226 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 33226 covers

An electrophysiologist or other cardiac-device implanting specialist repositions a transvenous lead used for left ventricular pacing, commonly in a cardiac resynchronization therapy system. The lead may need adjustment when its position has shifted or is not providing the intended pacing. The work is typically performed in a hospital electrophysiology or cardiac catheterization lab, with imaging used to guide lead manipulation.

Report 33226 for repositioning an existing left ventricular lead, rather than placing a new LV lead or repositioning a different pacing or defibrillator lead. The procedure note should identify the previously placed LV lead, the reason for revision, the repositioning performed, and its final position. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Medicare does not pay an assistant at surgery for this service; 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 33226 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

33226 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$384.87
AlaskaUnavailable$539.11
ArizonaUnavailable$411.24
ArkansasUnavailable$380.27
Atlanta, GAUnavailable$438.71
Austin, TXUnavailable$420.36
Bakersfield, CAUnavailable$409.36
Baltimore area, MDUnavailable$448.99
Beaumont, TXUnavailable$411.81
Brazoria, TXUnavailable$410.02

33226 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
33226 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 33226 rate is calculated

Each of 33226’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 · 33226

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.46

8.46 RVUs× 1.000 GPCI

Practice expense2.20

2.20 RVUs× 1.000 GPCI

Malpractice2.01

2.01 RVUs× 1.000 GPCI

Adjusted RVUs

12.6700

Conversion factor

$33.4009

Medicare rate

$423.19

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

Payment rules and modifiers for 33226

The CMS indicators that decide how 33226 is paid alongside other services.

CMS payment indicators · 33226

LV lead repositioning, previously placed transvenous lead

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33226 without 51 · national facility

$423.19

LV lead repositioning, previously placed transvenous lead

33226-51 · Second procedure: 50%

$211.60

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

33226 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 33226

    LV lead repositioning, previously placed transvenous lead8.46 wRVU

    Not priced

  • 33215

    Lead repositioning, pacing-defibrillator lead4.8 wRVU

    Not priced

  • 33225

    LV pacing lead, add-on with generator procedure8.12 wRVU

    Not priced

  • 33224

    LV pacing lead, includes generator connection8.81 wRVU

    Not priced

How to choose

33215Lead repositioningPacing-defibrillator lead
Use 33226 for repositioning a previously placed transvenous LV lead. Use 33215 for repositioning another type of transvenous pacemaker or defibrillator electrode.
33225LV pacing leadAdd-on with generator procedure
33225 covers placement of an LV pacing lead as an add-on service. 33226 is for repositioning an LV lead that was already placed.
33224LV pacing leadIncludes generator connection
33224 describes insertion and connection of an LV pacing lead. Choose 33226 when the service is repositioning an existing LV lead instead of inserting one.

Codes related to 33226

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

Codes related to 33226
CodeHow it relatesNational office range
Used instead
33215Lead repositioning, pacing-defibrillator leadRepositioning a different transvenous pacemaker or defibrillator electrode.No office rate
33225LV pacing lead, add-on with generator procedureAdd-on service for placing an LV pacing lead, rather than repositioning an existing one.No office rate
33224LV pacing lead, includes generator connectionLV pacing lead insertion and connection, not repositioning of a previously placed lead.No office rate

33226 billing questions

How does 33226 differ from 33215?

33226 is for repositioning a previously placed transvenous left ventricular lead. 33215 applies to repositioning a different transvenous pacemaker or defibrillator electrode.

Should 33226 be used for a newly placed LV lead?

No. It describes repositioning a previously placed LV lead. Code selection for a new lead depends on the insertion service performed.

What documentation supports 33226?

Document that the lead was previously implanted and identify it as the LV pacing lead. Include the reason for repositioning, the work performed, and the lead's final position.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

How is 33226 paid when other procedures occur in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 33226PPRRVU2026_Oct_nonQPP.csv, line 3,855 (RVU26D)

Open CMS sourceHow we calculate rates

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