CPT code 33240: Defibrillator generator, single existing lead2026 Medicare rate & RVUs in Maryland
Reports insertion of an implantable defibrillator pulse generator connected to an existing single lead, without placing a new lead.
CMS doesn’t publish an office rate for 33240 in Maryland.
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 33240 covers
The service places an implantable cardioverter-defibrillator (ICD) pulse generator and connects it to one previously implanted lead. The lead is retained; this code does not describe placing a new defibrillator lead. Electrophysiologists and cardiac surgeons typically perform the procedure in a hospital operating room or electrophysiology setting when the generator is being inserted separately from lead placement.
Report the code when the operative record supports generator insertion with an existing single-lead system, rather than insertion of a complete system or a generator exchange. Documentation should identify the existing lead and describe generator placement and connection. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. For multiple procedures in one session, CMS pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; 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 33240 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $340.26 |
| Rest of Maryland | Unavailable | $319.57 |
| Washington, DC area | Unavailable | $350.98 |
How the 33240 rate is calculated
Each of 33240’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 · 33240
RVUs × geographic indexes × conversion factor
Work5.66
5.66 RVUs× 1.000 GPCI
Practice expense2.59
2.59 RVUs× 1.000 GPCI
Malpractice1.34
1.34 RVUs× 1.000 GPCI
Adjusted RVUs
9.5900
Conversion factor
$33.4009
Medicare rate
$320.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33240
33240 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33240
Defibrillator generator, single existing lead
| 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 · 33240
Defibrillator generator, single existing 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33240 without 51 · national facility
$320.31
Defibrillator generator, single existing lead
33240-51 · Second procedure: 50%
$160.16
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%).
33240 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33230ICD generatorExisting dual leads
- 33230 is the generator-only insertion code for an existing dual-lead system; 33240 is for an existing single lead.
- 33249Defibrillator implantComplete transvenous system
- 33249 covers ICD system insertion or replacement with transvenous lead placement. Use 33240 when the existing single lead is retained and only the generator is inserted.
- 33262Defibrillator exchangeSingle-lead system
- 33262 describes removal and replacement of a generator in a single-lead system. Code 33240 describes generator insertion, not generator exchange.
- 33241ICD generator removalGenerator only
- 33241 describes removal of an ICD pulse generator without insertion of a new generator; 33240 describes generator insertion with an existing single lead.
33240 billing questions
Does this code include placement of a defibrillator lead?
No. It covers generator insertion connected to an existing single lead; it does not describe placing a new lead.
How does this differ from code 33249?
Use 33240 for generator insertion with an existing single lead. Code 33249 describes insertion or replacement of an ICD system with transvenous lead placement.
Is this the code for replacing an existing generator?
No. For an exchange of the generator in a single-lead system, compare code 33262, which describes removal and replacement of the generator.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code; a single generator and its lead are not a bilateral service.
How does the 90-day global period affect postoperative visits?
The global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
Is assistant-at-surgery payment available?
No. CMS lists a statutory restriction on assistant-at-surgery payment for this procedure.
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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