CPT code 33234: Pacemaker lead removal, single-lead transvenous system2026 Medicare rate & RVUs in California
Reports transvenous removal of a pacing electrode from a single-lead pacemaker system, such as for lead malfunction or device infection.
CMS doesn’t publish an office rate for 33234 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 33234 covers
This service removes a transvenous pacing electrode from a single-lead pacemaker system, whether the lead is atrial or ventricular. It is typically performed by an electrophysiologist or another physician experienced in lead extraction in a hospital setting. Clinical circumstances may include an infected device system or a malfunctioning lead requiring removal. This code describes electrode removal, not removal of the pacemaker pulse generator alone.
Select the code based on the single-lead system and the removal approach. The operative report should identify the system configuration, the electrode removed, the transvenous approach, and the clinical reason for extraction. If the generator is also removed, code 33233 describes that separate service. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and 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 33234 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $422.56 |
| Chico, CA | Unavailable | $417.77 |
| El Centro, CA | Unavailable | $418.07 |
| Fresno, CA | Unavailable | $417.77 |
| Hanford, CA | Unavailable | $417.77 |
| Los Angeles, CA | Unavailable | $441.81 |
| Madera, CA | Unavailable | $417.77 |
| Marin County, CA | Unavailable | $470.68 |
| Merced, CA | Unavailable | $417.77 |
| Modesto, CA | Unavailable | $417.77 |
| Napa, CA | Unavailable | $454.45 |
| Oxnard, CA | Unavailable | $436.03 |
| Redding, CA | Unavailable | $417.77 |
| Rest of California | Unavailable | $417.77 |
| Riverside, CA | Unavailable | $436.66 |
| Sacramento, CA | Unavailable | $430.62 |
| Salinas, CA | Unavailable | $428.88 |
| San Benito County, CA | Unavailable | $482.81 |
| San Diego, CA | Unavailable | $433.46 |
| San Francisco, CA | Unavailable | $468.68 |
| San Luis Obispo, CA | Unavailable | $422.97 |
| Santa Clara County, CA | Unavailable | $474.64 |
| Santa Cruz, CA | Unavailable | $433.16 |
| Santa Maria, CA | Unavailable | $428.98 |
| Santa Rosa, CA | Unavailable | $436.98 |
| Stockton, CA | Unavailable | $417.77 |
| Vallejo, CA | Unavailable | $451.57 |
| Visalia, CA | Unavailable | $417.77 |
| Yuba City, CA | Unavailable | $417.77 |
How the 33234 rate is calculated
Each of 33234’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 · 33234
RVUs × geographic indexes × conversion factor
Work7.47
7.47 RVUs× 1.000 GPCI
Practice expense3.62
3.62 RVUs× 1.000 GPCI
Malpractice1.76
1.76 RVUs× 1.000 GPCI
Adjusted RVUs
12.8500
Conversion factor
$33.4009
Medicare rate
$429.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33234
33234 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33234
Pacemaker lead removal, single-lead transvenous 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) | 0 | Not 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 · 33234
Pacemaker lead removal, single-lead transvenous 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
33234 without 51 · national facility
$429.20
Pacemaker lead removal, single-lead transvenous system
33234-51 · Second procedure: 50%
$214.60
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%).
33234 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33233Pacemaker generator removalWithout replacement
- 33233 describes removal of the pacemaker pulse generator. Use 33234 for removal of the electrode from a single-lead system.
- 33235Pacemaker lead removalDual-lead system
- 33235 applies to a dual-lead pacemaker system; 33234 is for a single-lead system.
- 33244ICD lead extractionTransvenous approach
- 33244 describes transvenous electrode extraction for an implantable defibrillator system, not a pacemaker system.
33234 billing questions
How does 33234 differ from 33235?
33234 is for removal from a single-lead pacemaker system, with an atrial or ventricular lead. Code 33235 is for a dual-lead system.
Does 33234 include removal of the pulse generator?
No. It describes electrode removal; code 33233 describes removal of a pacemaker pulse generator. When both are removed, document each service performed.
Is this code reported for each part of the lead?
Code selection is based on the pacemaker system configuration, not on separate portions of one electrode. Document the single-lead system and the electrode removed.
Can modifier 50 be used for right- and left-sided leads?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor and anatomy do not support modifier 50.
What documentation supports reporting 33234?
The operative report should establish a single-lead pacemaker system, identify the atrial or ventricular electrode removed, describe the transvenous removal, and state the clinical indication.
How does the 90-day global affect follow-up care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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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