CPT code 33243: ICD lead removal, by thoracotomy2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $1,303.99 for 33243 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 33243 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 33243 covers

This service removes an implantable cardioverter-defibrillator (ICD) lead through an open chest approach. It is performed in an operating room, typically by a cardiac surgeon or cardiothoracic surgeon, when the lead is removed surgically rather than extracted through the veins. The code represents lead removal; removal of the pulse generator is a separate service. The transvenous extraction approach is reported with a different code.

Select this code when the operative report documents thoracotomy access and removal of an ICD lead. Documentation should identify the device and lead removed, the surgical approach, and any separately performed generator removal. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple 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. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is not appropriate.

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.

How Puerto Rico compares for 33243

Across 109 of 109 payment localities, the facility rate for 33243 runs from $1,158.69 in Wisconsin to $1,625.23 in Alaska. Puerto Rico pays $1,303.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

33243 rates by state

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

See 33243 in every payment locality

How the 33243 rate is calculated

Each of 33243’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.

Payment rules and modifiers for 33243

33243 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 33243

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

How 33243 has changed in Puerto Rico

Price 33243 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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

Open CMS sourceHow we calculate rates