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Billing code 33220: Lead repairMedicare rate & RVUs

Reports operative repair of two existing transvenous pacing or defibrillation leads when both leads are repaired rather than repositioned or replaced.

CMS RVU26DEffective Oct 1, 2026109 payment localities70 Medicare services in 2024

Medicare pays $341.36 for 33220 nationally in a facility.

Medicare rate · 33220

Lead repair

Swap in your local Medicare rate.

Work RVUs
5.75
Total RVUs
10.22
Global days
090

National rate · 2026

$341.36

Facility setting, before claim adjustments.

See every locality for 33220 → · 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 33220 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 33220 covers

33220 represents operative repair of two existing transvenous leads serving a pacemaker or implantable cardioverter-defibrillator system. An electrophysiologist or another physician performing cardiac device surgery typically carries out the work in a hospital or other surgical facility. The defining distinction is repair of two leads, rather than correction of a lead’s position or placement of new electrodes.

Report the code when the operative record supports repair of both existing leads. Document the number of leads and the repair performed so the service can be distinguished from repositioning or insertion. Modifier 50 should not represent the two repaired leads. Medicare assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is 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.

Where 33220 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

33220 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$308.66
Alaska*Unavailable$423.74
ArizonaUnavailable$331.60
ArkansasUnavailable$304.68
AtlantaUnavailable$352.73
AustinUnavailable$342.59
BakersfieldUnavailable$337.22
Baltimore/Surr. CntysUnavailable$362.78
BeaumontUnavailable$328.78
BrazoriaUnavailable$331.97

33220 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
33220 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 33220 rate is calculated

Each of 33220’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 · 33220

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.75Practice expense 3.11Malpractice 1.36

10.2200 adjusted RVUs×$33.4009 conversion factor=$341.36

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

Payment rules and modifiers for 33220

33220 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33220

Lead repair

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 · 33220

Lead repair

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

33220 without 51 · national facility

$341.36

Lead repair

33220-51 · Second procedure: 50%

$170.68

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

33220 compared with similar codes

Compare codes

33220 vs 33218 vs 33215 vs 33217: national Medicare rates

Swap in your local Medicare rate.

  • 33220
    Lead repair · 5.75 wRVU
    —
  • 33218
    Lead repair · 5.67 wRVU
    —
  • 33215
    Lead repositioning · 4.8 wRVU
    —
  • 33217
    Lead insertion · 5.45 wRVU
    —

How to choose

33218Lead repair
33218 describes repair of one existing pacing-defibrillation lead. Report 33220 when two leads are repaired.
33215Lead repositioning
33215 is for repositioning an existing lead. 33220 is for repairing two existing leads, not changing their position.
33217Lead insertion
33217 describes insertion of two new pacing-defibrillation electrodes. 33220 describes repair of two existing leads.

Codes related to 33220

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

Codes related to 33220
CodeHow it relatesNational office range
Same family
33218Lead repairRepair of one pacing-defibrillation lead; 33220 represents repair of two.No office rate
Used instead
33215Lead repositioningUsed for repositioning an existing pacing-defibrillation lead rather than repairing two leads.No office rate
33216ICD lead insertionInsertion of one new pacing-defibrillation electrode when repair is not the service performed.No office rate
33217Lead insertionInsertion of two new pacing-defibrillation electrodes, rather than repair of two existing leads.No office rate

33220 billing questions

How does 33220 differ from 33218?

33220 is for repair of two existing leads; 33218 is for repair of one. Select according to the number of leads repaired.

Should modifier 50 be used for two repaired leads?

No. The two-lead service is represented by 33220 itself; modifier 50 should not be used to represent the lead count.

When is 33215 a better fit?

Use 33215 when the work repositions an existing pacing-defibrillation lead. Use 33220 when two existing leads are repaired.

What documentation supports reporting 33220?

The operative report should identify both existing leads and describe the repair performed on each, distinguishing repair from repositioning or insertion.

How does the 90-day global period affect postoperative billing?

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

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 33220PPRRVU2026_Oct_nonQPP.csv, line 3,849 (RVU26D)

Open CMS sourceHow we calculate rates

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