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Billing code 33216: ICD lead insertionMedicare rate & RVUs

Reports placement of one transvenous lead for an implantable cardioverter-defibrillator when the service is lead insertion rather than implantation of the complete system.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.1K Medicare services in 2024

Medicare pays $331.34 for 33216 nationally in a facility.

Medicare rate · 33216

ICD lead insertion

Swap in your local Medicare rate.

Work RVUs
5.48
Total RVUs
9.92
Global days
090

National rate · 2026

$331.34

Facility setting, before claim adjustments.

See every locality for 33216 → · 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 33216 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 33216 covers

A cardiac electrophysiologist or other qualified physician places one transvenous electrode for an implantable cardioverter-defibrillator, advancing it through venous access into the heart and securing it in position. The work is typically performed in a hospital electrophysiology laboratory or operating room. This code describes lead placement, such as adding a new ICD lead to an existing system; it is distinct from implanting the complete generator-and-lead system.

Report the single-lead service when documentation supports insertion of one ICD electrode, not two leads, repositioning, or repair of an existing lead. The operative report should identify the device purpose, number of leads inserted, and relevant placement work. CMS assigns a 90-day global period, including 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% multiple-procedure reduction. CMS does not pay an assistant at surgery for this code; 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 33216 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

33216 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$299.49
Alaska*Unavailable$410.35
ArizonaUnavailable$321.87
ArkansasUnavailable$295.60
AtlantaUnavailable$342.23
AustinUnavailable$332.89
BakersfieldUnavailable$328.07
Baltimore/Surr. CntysUnavailable$352.16
BeaumontUnavailable$318.81
BrazoriaUnavailable$322.38

33216 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
33216 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 33216 rate is calculated

Each of 33216’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 · 33216

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.48Practice expense 3.15Malpractice 1.29

9.9200 adjusted RVUs×$33.4009 conversion factor=$331.34

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

Payment rules and modifiers for 33216

33216 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33216

ICD lead insertion

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 · 33216

ICD lead insertion

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

33216 without 51 · national facility

$331.34

ICD lead insertion

33216-51 · Second procedure: 50%

$165.67

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

33216 compared with similar codes

Compare codes

33216 vs 33217 vs 33249 vs 33215 vs 33240: national Medicare rates

Swap in your local Medicare rate.

  • 33216
    ICD lead insertion · 5.48 wRVU
    —
  • 33217
    Lead insertion · 5.45 wRVU
    —
  • 33249
    Defibrillator implant · 14.55 wRVU
    —
  • 33215
    Lead repositioning · 4.8 wRVU
    —
  • 33240
    Defibrillator generator · 5.66 wRVU
    —

How to choose

33217Lead insertion
Choose 33216 for one transvenous ICD lead and 33217 for two. The operative record should establish the number inserted.
33249Defibrillator implant
33249 represents implantation of the complete transvenous ICD system. 33216 represents single-lead insertion, not the complete generator-and-lead implant.
33215Lead repositioning
33215 is for repositioning an existing pacing-defibrillator lead; 33216 is for insertion of a new single lead.
33240Defibrillator generator
33240 covers ICD pulse-generator insertion or replacement. It does not describe insertion of a new transvenous lead.

Codes related to 33216

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

Codes related to 33216
CodeHow it relatesNational office range
Same family
33217Lead insertionInsertion of two transvenous ICD electrodes; the lead count distinguishes it from 33216.No office rate
Used instead
33249Defibrillator implantReports implantation of the complete transvenous ICD system rather than lead insertion alone.No office rate
33215Lead repositioningApplies when an existing pacing-defibrillator lead is repositioned instead of inserting a new lead.No office rate
33218Lead repairApplies to repair of one existing pacing-defibrillator electrode rather than insertion of a new one.No office rate
33240Defibrillator generatorReports ICD pulse-generator insertion or replacement when generator work, rather than lead placement, is performed.No office rate

33216 billing questions

How does 33216 differ from 33217?

33216 is for insertion of one transvenous ICD lead; 33217 is for insertion of two. Use the operative documentation to establish the number of electrodes placed.

Can 33216 be reported for a complete ICD implant?

No. When the service is implantation of the complete transvenous ICD system, including its generator and lead work, consider 33249 rather than reporting lead insertion as though it were a separate complete-system service.

When is 33215 more appropriate?

33215 describes repositioning an already implanted pacing-defibrillator lead. Use 33216 when a new single lead is inserted, not when the existing lead is moved.

Does 33216 include ICD generator work?

This code represents insertion of one lead, not insertion or replacement of the ICD pulse generator. Code generator work separately only when the documented service and applicable coding rules support it.

What documentation supports 33216?

The operative report should show that one transvenous ICD electrode was newly placed and distinguish that work from placement of two leads, lead repositioning, or lead repair.

How does the 90-day global period affect billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period. For multiple procedures in one session, CMS pays the highest-valued procedure in full and applies the standard reduction to the others.

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 33216PPRRVU2026_Oct_nonQPP.csv, line 3,845 (RVU26D)

Open CMS sourceHow we calculate rates

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