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Billing code 33212: Pacemaker generatorMedicare rate & RVUs

Reports insertion of a pacemaker pulse generator connected to an existing single-lead system, rather than placement of a new lead or generator replacement.

CMS RVU26DEffective Oct 1, 2026109 payment localities130 Medicare services in 2024

Medicare pays $292.26 for 33212 nationally in a facility.

Medicare rate · 33212

Pacemaker generator

Swap in your local Medicare rate.

Work RVUs
4.88
Total RVUs
8.75
Global days
090

National rate · 2026

$292.26

Facility setting, before claim adjustments.

See every locality for 33212 → · 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 33212 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 33212 covers

Code 33212 describes placing a pacemaker pulse generator for a system that already has one transvenous pacing lead. The generator is connected to that retained lead and seated in a surgically created pocket, commonly in the upper chest. Electrophysiologists and other physicians trained in cardiac device implantation perform this work in a hospital or ambulatory surgical setting. The defining distinction is generator-only insertion with one existing lead, rather than implantation of a new lead or replacement of an old generator.

Report 33212 when the operative record supports insertion of the generator and documents the single-lead configuration. Document that the existing lead was retained and connected, and identify the number of leads in the system. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When other procedures subject to the multiple-procedure rule occur in the same session, the highest-valued procedure is paid in full and additional procedures at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 33212 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

33212 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$264.13
Alaska*Unavailable$362.24
ArizonaUnavailable$283.87
ArkansasUnavailable$260.70
AtlantaUnavailable$301.98
AustinUnavailable$293.42
BakersfieldUnavailable$288.90
Baltimore/Surr. CntysUnavailable$310.66
BeaumontUnavailable$281.36
BrazoriaUnavailable$284.22

33212 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
33212 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 33212 rate is calculated

Each of 33212’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 · 33212

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.88Practice expense 2.71Malpractice 1.16

8.7500 adjusted RVUs×$33.4009 conversion factor=$292.26

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

Payment rules and modifiers for 33212

33212 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33212

Pacemaker generator

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)0Not permitted.
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 · 33212

Pacemaker generator

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

33212 without 51 · national facility

$292.26

Pacemaker generator

33212-51 · Second procedure: 50%

$146.13

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

33212 compared with similar codes

Compare codes

33212 vs 33213 vs 33221 vs 33227 vs 33207: national Medicare rates

Swap in your local Medicare rate.

  • 33212
    Pacemaker generator · 4.88 wRVU
    —
  • 33213
    Pacemaker generator · 5.15 wRVU
    —
  • 33221
    Pacemaker generator · 5.41 wRVU
    —
  • 33227
    Pacemaker generator exchange · 5.12 wRVU
    —
  • 33207
    Pacemaker insertion · 7.61 wRVU
    —

How to choose

33213Pacemaker generator
Use 33212 for an existing single-lead system and 33213 for an existing dual-lead system. The lead configuration, not the generator itself, distinguishes these codes.
33221Pacemaker generator
33221 is for generator insertion with an existing multiple-lead system; 33212 is limited to an existing single-lead system.
33227Pacemaker generator exchange
33227 covers removal and replacement of a generator in a single-lead system. Use 33212 for generator insertion rather than removal and replacement.
33207Pacemaker insertion
33207 describes insertion of a new permanent pacemaker system with a ventricular lead. Code 33212 is generator-only insertion with an existing single lead.

Codes related to 33212

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

Codes related to 33212
CodeHow it relatesNational office range
Same family
33213Pacemaker generatorGenerator insertion for an existing dual-lead pacemaker system.No office rate
33221Pacemaker generatorGenerator insertion for an existing multiple-lead pacemaker system.No office rate
Used instead
33227Pacemaker generator exchangeRemoval and replacement of a generator in a single-lead pacemaker system.No office rate
33206Pacemaker implantNew permanent pacemaker insertion with an atrial lead.No office rate
33207Pacemaker insertionNew permanent pacemaker insertion with a ventricular lead.No office rate

33212 billing questions

How does 33212 differ from 33213?

33212 is for generator insertion with an existing single-lead system. Use 33213 when the existing system has dual leads.

When is 33212 used instead of 33227?

33212 describes insertion of a generator for an existing single-lead system. Code 33227 describes removing and replacing a generator in a single-lead system.

What documentation supports 33212?

The operative report should support generator insertion and identify the existing lead configuration, including that the single lead was retained and connected.

What global period applies to 33212?

Medicare assigns a 90-day global period. The day-before preoperative visit and related postoperative care through day 90 are included.

Can an assistant or co-surgeon be billed for 33212?

Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing are not permitted.

How does the multiple-procedure rule affect 33212?

For procedures subject to the rule performed in the same session, Medicare pays the highest-valued procedure in full and pays additional procedures at 50%.

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 33212PPRRVU2026_Oct_nonQPP.csv, line 3,841 (RVU26D)

Open CMS sourceHow we calculate rates

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