CPT code 33270: Defibrillator implant, subcutaneous system2026 Medicare rate & RVUs

Medicare pays $493.00 for 33270 nationally in a facility.

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

What 33270 covers

This service covers placing or replacing a subcutaneous implantable cardioverter-defibrillator system, with the generator under the skin and an electrode positioned beneath the skin along the sternum. The physician also performs the system’s specified intraoperative testing, including arrhythmia induction and evaluation of defibrillation, sensing, or pacing function. Electrophysiologists and cardiac surgeons commonly perform the procedure in a hospital operating room or electrophysiology laboratory for patients who need protection from life-threatening ventricular arrhythmias and are receiving a subcutaneous rather than transvenous system.

Report 33270 for the complete system service, not when the work is limited to inserting an electrode. The operative report should identify whether the system was implanted or replaced, describe the subcutaneous generator and electrode placement, and document the testing performed. CMS assigns a 90-day global period; the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, 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 33270 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

33270 rates by state

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

How the 33270 rate is calculated

Each of 33270’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 33270

33270 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

33270 compared with similar codes

How to choose

33271Defibrillator electrodeSubcutaneous implantable system

33271 covers insertion of the subcutaneous electrode alone; 33270 covers implantation or replacement of the complete system and includes the electrode.

33249Defibrillator implantComplete transvenous system

33249 applies to a defibrillator system with transvenous lead(s). Choose 33270 for the complete subcutaneous system.

33262Defibrillator exchangeSingle-lead system

33262 is generator removal and replacement for a single-lead transvenous defibrillator system. It is not the code for replacing a complete subcutaneous system.

33272Defibrillator removalSubcutaneous system

33272 describes removal of a subcutaneous defibrillator electrode, not implantation or replacement of the complete system.

Codes related to 33270

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

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