FeeBase
Log inGet started
Menu

Billing code 33206: Pacemaker implantMedicare rate & RVUs

Reports implantation of a permanent transvenous pacemaker configured for atrial pacing, commonly for selected patients with sinus node dysfunction and preserved AV conduction.

CMS RVU26DEffective Oct 1, 2026109 payment localities987 Medicare services in 2024

Medicare pays $402.15 for 33206 nationally in a facility.

Medicare rate · 33206

Pacemaker implant

Swap in your local Medicare rate.

Work RVUs
6.96
Total RVUs
12.04
Global days
090

National rate · 2026

$402.15

Facility setting, before claim adjustments.

See every locality for 33206 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 33206 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 33206 covers

A cardiologist or electrophysiologist places a transvenous pacing lead in the atrium and connects it to a pulse generator, usually positioned in a pocket beneath the skin of the chest. This service is used for a permanent atrial pacing system, including selected patients with sinus node dysfunction and preserved atrioventricular conduction. Implantation commonly takes place in a hospital electrophysiology or cardiac catheterization lab.

Select this code when the implanted permanent system provides atrial pacing; use the chamber configuration documented in the operative report to distinguish it from ventricular-only or dual-chamber implantation. Documentation should identify the permanent system, lead placement, and generator implantation. The code represents the implant service, not a generator-only procedure or a charge per lead. It has a 90-day global period that includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this implant. Assistant-at-surgery payment is statutorily restricted; co-surgeons are permitted, but team surgery is not.

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 33206 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

33206 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$364.11
Alaska*Unavailable$501.43
ArizonaUnavailable$390.73
ArkansasUnavailable$359.49
AtlantaUnavailable$415.63
AustinUnavailable$403.09
BakersfieldUnavailable$396.34
Baltimore/Surr. CntysUnavailable$427.18
BeaumontUnavailable$387.91
BrazoriaUnavailable$390.99

33206 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
33206 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 33206 rate is calculated

Each of 33206’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 · 33206

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.96Practice expense 3.45Malpractice 1.63

12.0400 adjusted RVUs×$33.4009 conversion factor=$402.15

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 33206

33206 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33206

Pacemaker implant

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33206

Pacemaker implant

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33206 without 51 · national facility

$402.15

Pacemaker implant

33206-51 · Second procedure: 50%

$201.08

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%).

When to use modifier 51

33206 compared with similar codes

Compare codes

33206 vs 33207 vs 33208 vs 33210 vs 33212: national Medicare rates

Swap in your local Medicare rate.

  • 33206
    Pacemaker implant · 6.96 wRVU
    —
  • 33207
    Pacemaker insertion · 7.61 wRVU
    —
  • 33208
    Pacemaker implant · 8.31 wRVU
    —
  • 33210
    Temporary pacing · 2.97 wRVU
    —
  • 33212
    Pacemaker generator · 4.88 wRVU
    —

How to choose

33207Pacemaker insertion
Use 33207 when the permanent system is configured for ventricular-only pacing. 33206 identifies atrial pacing.
33208Pacemaker implant
Use 33208 when both atrial and ventricular pacing are provided. 33206 is for an atrial pacing configuration.
33210Temporary pacing
33210 is for temporary transvenous pacing catheter placement; 33206 is for implantation of a permanent atrial pacing system.
33212Pacemaker generator
33212 is for pulse-generator insertion in a single-lead system. 33206 describes implantation of the permanent atrial system, not generator insertion alone.

Codes related to 33206

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

Codes related to 33206
CodeHow it relatesNational office range
Same family
33207Pacemaker insertionSibling code for permanent transvenous pacing configured for ventricular-only pacing.No office rate
33208Pacemaker implantSibling code for a permanent system configured for both atrial and ventricular pacing.No office rate
Used instead
33210Temporary pacingTemporary transvenous pacing catheter placement rather than permanent atrial system implantation.No office rate
33212Pacemaker generatorPulse-generator insertion for a single-lead system, rather than implantation of the complete system.No office rate

33206 billing questions

How does 33206 differ from 33207 and 33208?

33206 is for a permanent system configured for atrial pacing. Use 33207 for ventricular-only pacing and 33208 for a system pacing both the atrium and ventricle.

Does 33206 include the pulse generator?

Yes. It represents implantation of the permanent atrial pacing system, including the transvenous lead and pulse generator; it is not a generator-only code.

Should the code be reported once per lead?

No. Report the implant service once for the procedure, not separately for each electrode.

Can an assistant surgeon be paid for 33206?

CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons are permitted, while team surgery is not.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

When is 33210 a better comparison?

33210 describes temporary transvenous pacing catheter placement. It is distinct from implantation of a permanent atrial pacing system.

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
RVUs for 33206PPRRVU2026_Oct_nonQPP.csv, line 3,835 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 33206 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 33206 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →