CPT code 33286: Monitor removal, implantable rhythm monitor2026 Medicare rate & RVUs in Fresno, CA
Report 33286 when a clinician removes an implanted subcutaneous cardiac rhythm monitor, such as an implantable loop recorder, from its pocket.
In Fresno, CA, Medicare pays $130.72 for 33286 in the office and $71.41 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 33286 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 33286 covers
A physician, often an electrophysiologist or cardiologist, removes an implanted subcutaneous cardiac rhythm monitor through an incision over the device. The clinician frees the monitor from the subcutaneous pocket, extracts it, and closes the incision. Removal may follow completion of diagnostic monitoring, battery depletion, or a decision to replace the device. The service is performed in office or facility settings where the implanted monitor can be removed.
Report 33286 for removal, not placement or device interrogation alone. Documentation should identify the implanted monitor, the reason for removal, and the work of extracting it. Pocket access, dissection, removal, and routine closure are part of the removal service. The 0-day global period includes same-day preoperative and postoperative care. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment is statutorily 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.
How Fresno, CA compares for 33286
Across 109 of 109 payment localities, the office rate for 33286 runs from $113.49 in Arkansas to $158.83 in San Benito County, CA. Fresno, CA pays $130.72. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Fresno, CA · this page$130.72
- Bakersfield, CA · California$131.69+$0.97
- Chico, CA · California$130.72
- El Centro, CA · California$130.78+$0.06
- Hanford, CA · California$130.72
- Los Angeles, CA · California$139.36+$8.64
- Madera, CA · California$130.72
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Merced, CACalifornia | $130.72 | $71.41 |
| Modesto, CACalifornia | $130.72 | $71.41 |
| Napa, CACalifornia | $147.75 | $76.44 |
| Oxnard, CACalifornia | $138.16 | $74.20 |
| Redding, CACalifornia | $130.72 | $71.41 |
| Rest of CaliforniaCalifornia | $130.72 | $71.41 |
| Riverside, CACalifornia | $134.58 | $75.27 |
| Sacramento, CACalifornia | $136.21 | $73.28 |
| Salinas, CACalifornia | $135.69 | $72.98 |
| San Diego, CACalifornia | $138.24 | $73.52 |
| Marin County, CACalifornia | $154.99 | $78.70 |
| San Francisco, CACalifornia | $154.58 | $78.29 |
| San Benito County, CACalifornia | $158.83 | $80.80 |
| Santa Clara County, CACalifornia | $157.16 | $79.13 |
| San Luis Obispo, CACalifornia | $133.65 | $72.02 |
| Santa Cruz, CACalifornia | $139.02 | $73.28 |
| Santa Maria, CACalifornia | $136.02 | $72.93 |
| Santa Rosa, CACalifornia | $140.35 | $73.90 |
| Stockton, CACalifornia | $130.72 | $71.41 |
| Vallejo, CACalifornia | $147.16 | $75.85 |
| Visalia, CACalifornia | $130.72 | $71.41 |
| Yuba City, CACalifornia | $130.72 | $71.41 |
| Washington, DC areaDistrict of Columbia | $145.05 | $81.31 |
| Miami, FLFlorida | $150.11 | $93.78 |
| Chicago, ILIllinois | $145.18 | $90.80 |
| Manhattan, NYNew York | $150.13 | $87.26 |
| AlaskaAlaska | $152.34 | $94.71 |
| AlabamaAlabama | $115.19 | $67.85 |
| ArkansasArkansas | $113.49 | $67.01 |
| ArizonaArizona | $125.08 | $72.65 |
| ColoradoColorado | $131.24 | $73.67 |
| ConnecticutConnecticut | $137.67 | $79.40 |
| DelawareDelaware | $127.14 | $73.68 |
| Fort Lauderdale, FLFlorida | $139.53 | $84.72 |
| Rest of FloridaFlorida | $131.98 | $80.25 |
| Atlanta, GAGeorgia | $132.58 | $77.61 |
| Rest of GeorgiaGeorgia | $123.88 | $75.61 |
| Hawaii, Guam, HIHawaii | $133.20 | $71.68 |
| IowaIowa | $115.89 | $66.37 |
| IdahoIdaho | $117.14 | $67.36 |
| East St. Louis, ILIllinois | $135.67 | $85.89 |
| Rest of IllinoisIllinois | $129.77 | $80.37 |
| Suburban Chicago, ILIllinois | $140.39 | $84.82 |
| IndianaIndiana | $117.77 | $67.61 |
| KansasKansas | $116.42 | $67.51 |
| KentuckyKentucky | $120.34 | $72.24 |
| New Orleans, LALouisiana | $126.54 | $75.63 |
| Rest of LouisianaLouisiana | $120.59 | $72.70 |
| Metropolitan Boston, MAMassachusetts | $142.82 | $78.22 |
| Rest of MassachusettsMassachusetts | $130.88 | $73.90 |
| Baltimore area, MDMaryland | $137.53 | $79.47 |
| Rest of MarylandMaryland | $129.25 | $74.49 |
| Rest of MaineMaine | $118.93 | $69.15 |
| Southern Maine, MEMaine | $123.88 | $70.25 |
| Detroit, MIMichigan | $134.79 | $82.58 |
| Rest of MichiganMichigan | $124.55 | $75.15 |
| MinnesotaMinnesota | $122.44 | $66.76 |
| Metropolitan Kansas City, MOMissouri | $124.49 | $73.69 |
| Metropolitan St. Louis, MOMissouri | $125.68 | $74.17 |
| Rest of MissouriMissouri | $119.21 | $72.57 |
| MississippiMississippi | $116.32 | $69.73 |
| MontanaMontana | $128.90 | $74.79 |
| North CarolinaNorth Carolina | $120.02 | $69.54 |
| North DakotaNorth Dakota | $121.79 | $67.68 |
| NebraskaNebraska | $116.20 | $66.26 |
| New HampshireNew Hampshire | $130.22 | $73.89 |
| Northern New JerseyNew Jersey | $143.72 | $80.95 |
| Rest of New JerseyNew Jersey | $138.31 | $79.23 |
| New MexicoNew Mexico | $125.69 | $76.07 |
| NevadaNevada | $126.99 | $72.82 |
| NYC suburbs and Long Island, NYNew York | $155.23 | $90.90 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $140.12 | $80.87 |
| Queens, NYNew York | $149.76 | $85.81 |
| Rest of New YorkNew York | $121.95 | $70.55 |
| OhioOhio | $123.10 | $73.69 |
| OklahomaOklahoma | $118.96 | $70.64 |
| Portland, OROregon | $134.19 | $74.08 |
| Rest of OregonOregon | $125.08 | $71.19 |
| Metropolitan Philadelphia, PAPennsylvania | $134.92 | $78.59 |
| Rest of PennsylvaniaPennsylvania | $122.68 | $73.01 |
| Puerto RicoPuerto Rico | $129.50 | $74.79 |
| Rhode IslandRhode Island | $130.80 | $74.91 |
| South CarolinaSouth Carolina | $121.95 | $71.95 |
| South DakotaSouth Dakota | $120.94 | $66.83 |
| TennesseeTennessee | $117.16 | $67.97 |
| Austin, TXTexas | $131.61 | $74.36 |
| Beaumont, TXTexas | $121.94 | $72.70 |
| Brazoria, TXTexas | $126.06 | $72.44 |
| Dallas, TXTexas | $127.39 | $73.49 |
| Fort Worth, TXTexas | $126.86 | $73.51 |
| Galveston, TXTexas | $126.77 | $73.04 |
| Houston, TXTexas | $133.36 | $79.63 |
| Rest of TexasTexas | $124.29 | $72.94 |
| UtahUtah | $123.61 | $72.75 |
| VirginiaVirginia | $124.23 | $71.04 |
| Virgin Islands, VIUnited States Virgin Islands | $129.50 | $74.79 |
| VermontVermont | $122.31 | $68.74 |
| Rest of WashingtonWashington | $130.30 | $73.32 |
| King County, WAWashington | $144.63 | $78.24 |
| WisconsinWisconsin | $117.74 | $65.91 |
| West VirginiaWest Virginia | $125.18 | $78.16 |
| WyomingWyoming | $125.80 | $71.69 |
33286 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$113.49
$152.34
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $152.34 | 1 |
| AL | $115.19 | 1 |
| AR | $113.49 | 1 |
| AZ | $125.08 | 1 |
| CA | $130.72–$158.83 | 29 |
| CO | $131.24 | 1 |
| CT | $137.67 | 1 |
| DC | $145.05 | 1 |
| DE | $127.14 | 1 |
| FL | $131.98–$150.11 | 3 |
| GA | $123.88–$132.58 | 2 |
| GU | $133.20 | 1 |
| HI | $133.20 | 1 |
| IA | $115.89 | 1 |
| ID | $117.14 | 1 |
| IL | $129.77–$145.18 | 4 |
| IN | $117.77 | 1 |
| KS | $116.42 | 1 |
| KY | $120.34 | 1 |
| LA | $120.59–$126.54 | 2 |
| MA | $130.88–$142.82 | 2 |
| MD | $129.25–$145.05 | 3 |
| ME | $118.93–$123.88 | 2 |
| MI | $124.55–$134.79 | 2 |
| MN | $122.44 | 1 |
| MO | $119.21–$125.68 | 3 |
| MS | $116.32 | 1 |
| MT | $128.90 | 1 |
| NC | $120.02 | 1 |
| ND | $121.79 | 1 |
| NE | $116.20 | 1 |
| NH | $130.22 | 1 |
| NJ | $138.31–$143.72 | 2 |
| NM | $125.69 | 1 |
| NV | $126.99 | 1 |
| NY | $121.95–$155.23 | 5 |
| OH | $123.10 | 1 |
| OK | $118.96 | 1 |
| OR | $125.08–$134.19 | 2 |
| PA | $122.68–$134.92 | 2 |
| PR | $129.50 | 1 |
| RI | $130.80 | 1 |
| SC | $121.95 | 1 |
| SD | $120.94 | 1 |
| TN | $117.16 | 1 |
| TX | $121.94–$133.36 | 8 |
| UT | $123.61 | 1 |
| VA | $124.23–$145.05 | 2 |
| VI | $129.50 | 1 |
| VT | $122.31 | 1 |
| WA | $130.30–$144.63 | 2 |
| WI | $117.74 | 1 |
| WV | $125.18 | 1 |
| WY | $125.80 | 1 |
How the 33286 rate is calculated
Each of 33286’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 · 33286
RVUs × geographic indexes × conversion factor
Work1.46
1.46 RVUs× 1.000 GPCI
Practice expense2.04
2.04 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
3.8600
Conversion factor
$33.4009
Medicare rate
$128.93
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Fresno, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,906
- Code
- 33286
- Physician work
- 1.46
- Practice expense
- 2.04
- Malpractice
- 0.36
GPCI2026.csv
11
- Locality
- Fresno, CA
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.46 | × 1.017 | 1.4848 |
| Practice expense | 2.04 | × 1.096 | 2.2358 |
| Malpractice | 0.36 | × 0.536 | 0.1930 |
| Total RVUs | 3.9136 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Fresno, CA$130.72
Office: (1.46 × 1.017 + 2.04 × 1.096 + 0.36 × 0.536) × $33.4009 = $130.72
Facility: (1.46 × 1.017 + 0.42 × 1.096 + 0.36 × 0.536) × $33.4009 = $71.41
Payment rules and modifiers for 33286
The CMS indicators that decide how 33286 is paid alongside other services.
CMS payment indicators · 33286
Monitor removal, implantable rhythm monitor
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33286 without 51 · national office
$128.93
Monitor removal, implantable rhythm monitor
33286-51 · Second procedure: 50%
$64.47
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%).
How 33286 has changed in Fresno, CA
33286 · Office / nonfacility
$130.72
Effective 2026-10-01
The base rate is $5.01 higher than on 2025-10-01, moving from $125.71 to $130.72 (4.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$125.71changed to$130.72
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.50 changed to 1.46
- Practice expense RVU 1.99 changed to 2.04
- Malpractice RVU 0.34 changed to 0.36
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$130.83changed to$125.71
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.03 changed to 1.99
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$128.69changed to$130.83
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$135.35changed to$128.69
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.10 changed to 2.03
- Work GPCI 1.021 changed to 1.014
- Practice expense GPCI 1.079 changed to 1.093
- Malpractice GPCI 0.579 changed to 0.560
January 1, 2023
RVU23A
$139.57changed to$135.35
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.15 changed to 2.10
- Work GPCI 1.027 changed to 1.021
- Practice expense GPCI 1.065 changed to 1.079
- Malpractice GPCI 0.597 changed to 0.579
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$142.59changed to$139.57
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.20 changed to 2.15
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$138.62changed to$142.59
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.97 changed to 2.20
- Work GPCI 1.024 changed to 1.027
- Practice expense GPCI 1.070 changed to 1.065
- Malpractice GPCI 0.580 changed to 0.597
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$137.71changed to$138.62
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.95 changed to 1.97
- Malpractice RVU 0.35 changed to 0.34
- Work GPCI 1.020 changed to 1.024
- Practice expense GPCI 1.074 changed to 1.070
- Malpractice GPCI 0.562 changed to 0.580
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$137.71
Held through RVU19B, RVU19C, RVU19D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $130.72 | $71.41 | RVU26D |
| 2026-07-01 | $130.72 | $71.41 | RVU26C |
| 2026-04-01 | $130.72 | $71.41 | RVU26B |
| 2026-01-01 | $130.72 | $71.41 | RVU26A |
| 2025-10-01 | $125.71 | $79.75 | RVU25D |
| 2025-07-01 | $125.71 | $79.75 | RVU25C |
| 2025-04-01 | $125.71 | $79.75 | RVU25B |
| 2025-01-01 | $125.71 | $79.75 | RVU25A |
| 2024-10-01 | $130.83 | $81.71 | RVU24D |
| 2024-07-01 | $130.83 | $81.71 | RVU24C |
| 2024-04-01 | $130.83 | $81.71 | RVU24B |
| 2024-03-09 | $130.83 | $81.71 | RVU24AR |
| 2024-01-01 | $128.69 | $80.38 | RVU24A |
| 2023-10-01 | $135.35 | $84.53 | RVU23D |
| 2023-07-01 | $135.35 | $84.53 | RVU23C |
| 2023-04-01 | $135.35 | $84.53 | RVU23B |
| 2023-01-01 | $135.35 | $84.53 | RVU23A |
| 2022-10-01 | $139.57 | $86.50 | RVU22D |
| 2022-07-01 | $139.57 | $86.50 | RVU22C |
| 2022-04-01 | $139.57 | $86.50 | RVU22B |
| 2022-01-01 | $139.57 | $86.50 | RVU22A |
| 2021-10-01 | $142.59 | $87.22 | RVU21D |
| 2021-07-01 | $142.59 | $87.22 | RVU21C |
| 2021-04-01 | $142.59 | $87.22 | RVU21B |
| 2021-01-01 | $142.59 | $87.22 | RVU21A |
| 2020-10-01 | $138.62 | $89.20 | RVU20D |
| 2020-07-01 | $138.62 | $89.20 | RVU20C |
| 2020-04-01 | $138.62 | $89.20 | RVU20B |
| 2020-01-01 | $138.62 | $89.20 | RVU20A |
| 2019-10-01 | $137.71 | $88.94 | RVU19D |
| 2019-07-01 | $137.71 | $88.94 | RVU19C |
| 2019-04-01 | $137.71 | $88.94 | RVU19B |
| 2019-01-01 | $137.71 | $88.94 | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Fresno, CA rate applies
Fresno, CA is a Medicare payment area, not a city. Our Census mapping connects it to 45 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Fresno
- Auberry
- Big Creek
- Biola
- Bowles
- Calwa
- Cantua Creek
- Caruthers
33286 billing questions
When should 33286 be chosen instead of 33285?
Use 33286 for removal of an implanted subcutaneous cardiac rhythm monitor. Use 33285 for placement; when an old monitor is removed and a new one placed in the same session, both services may be reported when supported.
Is routine pocket closure separately reported?
Routine access, pocket dissection, extraction, and closure are part of the removal service. Separate reporting requires a distinct, separately supported service.
Can modifier 50 be used when monitors are removed from both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included in the procedure.
How is 33286 paid when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%. The assistant-at-surgery statutory restriction applies, and co-surgeons and team surgery are not permitted.
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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