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CPT 33222: Pocket relocationMedicare rate & RVUs

Reports surgical relocation of an existing pacemaker generator into a different pocket, such as when the current pocket causes discomfort or threatens the overlying skin.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.7K Medicare services in 2024

Medicare pays $310.29 for 33222 nationally in a facility.

Medicare rate · 33222

Pocket relocation

Swap in your local Medicare rate.

Work RVUs
4.73
Total RVUs
9.29
Global days
090

National rate · 2026

$310.29

Facility setting, before claim adjustments.

See every locality for 33222 → · 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 33222 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 33222 covers

The surgeon frees the existing pacemaker generator from its pocket and moves it into a newly created pocket at a different site. This procedure is typically performed by a cardiac electrophysiologist or cardiothoracic surgeon in a hospital operating room when the existing pocket’s position or condition requires relocation. The service addresses the generator pocket, not repositioning a pacing lead or implanting a new generator.

Report the procedure when the operative record supports relocation of the pacemaker pocket and generator; distinguish it from generator replacement or lead repositioning. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of 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. Modifier 50 is inappropriate. Medicare 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 33222 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

33222 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$279.70
Alaska*Unavailable$379.96
ArizonaUnavailable$301.35
ArkansasUnavailable$275.95
AtlantaUnavailable$320.13
AustinUnavailable$313.01
BakersfieldUnavailable$309.70
Baltimore/Surr. CntysUnavailable$330.08
BeaumontUnavailable$297.30
BrazoriaUnavailable$302.29

33222 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
33222 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 33222 rate is calculated

Each of 33222’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 · 33222

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.73Practice expense 3.44Malpractice 1.12

9.2900 adjusted RVUs×$33.4009 conversion factor=$310.29

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

Payment rules and modifiers for 33222

33222 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33222

Pocket relocation

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 · 33222

Pocket relocation

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

33222 without 51 · national facility

$310.29

Pocket relocation

33222-51 · Second procedure: 50%

$155.15

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

33222 compared with similar codes

Compare codes

33222 vs 33223 vs 33215 vs 33228: national Medicare rates

Swap in your local Medicare rate.

  • 33222
    Pocket relocation · 4.73 wRVU
    —
  • 33223
    Defibrillator pocket · 6.14 wRVU
    —
  • 33215
    Lead repositioning · 4.8 wRVU
    —
  • 33228
    Pacemaker generator exchange · 5.38 wRVU
    —

How to choose

33223Defibrillator pocket
Use 33222 for relocation of a pacemaker generator pocket; 33223 covers relocation of a defibrillator pocket.
33215Lead repositioning
33215 addresses repositioning a pacing-defibrillator lead. It does not describe moving the pacemaker generator to a new pocket.
33228Pacemaker generator exchange
33228 covers replacement of a dual-lead pacemaker generator. Choose based on whether the documented work replaces the generator or relocates its pocket.

Codes related to 33222

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

Codes related to 33222
CodeHow it relatesNational office range
Used instead
33223Defibrillator pocketRelocates a defibrillator pocket rather than a pacemaker pocket.No office rate
33215Lead repositioningRepositions a pacing-defibrillator lead rather than relocating the generator pocket.No office rate
33228Pacemaker generator exchangeReplaces a dual-lead pacemaker generator when replacement, rather than pocket relocation, is performed.No office rate

33222 billing questions

How is this different from pacemaker lead repositioning?

33222 relocates the generator pocket. When the work repositions a pacing lead rather than the generator pocket, consider the lead-repositioning code 33215.

How does this differ from defibrillator pocket relocation?

33222 is for a pacemaker generator pocket. Code 33223 is the corresponding pocket-relocation code for a defibrillator.

Can this be reported when the generator is replaced?

The operative documentation should distinguish pocket relocation from generator replacement, such as 33228 for replacement of a dual-lead pacemaker generator. Do not treat replacement alone as pocket relocation.

Does modifier 50 apply?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

What postoperative care is included?

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

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 33222PPRRVU2026_Oct_nonQPP.csv, line 3,851 (RVU26D)

Open CMS sourceHow we calculate rates

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