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CPT code 33244: ICD lead extraction2026 Medicare rate & RVUs

Removal of an implantable cardioverter-defibrillator lead through the venous system, typically for infection, malfunction, or system revision.

CMS RVU26DEffective Oct 1, 2026109 payment localities3K Medicare services in 2024

Medicare pays $766.55 for 33244 nationally in a facility.

Medicare rate · 33244

ICD lead extraction

Office or facility?

Work RVUs
13.4
Total RVUs
22.95
Global days
090

National rate · 2026

$766.55

Facility setting, before claim adjustments.

See every locality for 33244 →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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 33244 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 33244 covers

This service removes one or more implantable cardioverter-defibrillator (ICD) leads through the venous system. The physician may use specialized extraction sheaths and related tools to free leads from scar tissue. Electrophysiologists commonly perform the procedure in a hospital electrophysiology laboratory or operating room, often with surgical support available because extraction can carry serious risks. The code is for ICD leads, not pacemaker leads, and the approach is transvenous rather than through a thoracotomy.

Select the code when the record supports extraction of an ICD lead by the transvenous route. Document the device and lead type, the extraction approach, and the work performed; report separate generator removal when that service is also performed. The 90-day global period includes the day-before preoperative visit and related postoperative care. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment is restricted by statute; co-surgeons require supporting documentation, and team surgery is 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 33244 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

33244 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$693.86
AlaskaUnavailable$956.48
ArizonaUnavailable$744.66
ArkansasUnavailable$685.04
Atlanta, GAUnavailable$792.65
Austin, TXUnavailable$767.68
Bakersfield, CAUnavailable$753.95
Baltimore area, MDUnavailable$814.42
Beaumont, TXUnavailable$739.86
Brazoria, TXUnavailable$744.85

33244 rates by state

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

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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
33244 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 33244 rate is calculated

Each of 33244’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 · 33244

RVUs × geographic indexes × conversion factor

Office or facility?

Work13.40

13.40 RVUs× 1.000 GPCI

Practice expense6.37

6.37 RVUs× 1.000 GPCI

Malpractice3.18

3.18 RVUs× 1.000 GPCI

Adjusted RVUs

22.9500

Conversion factor

$33.4009

Medicare rate

$766.55

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 33244

33244 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33244

ICD lead extraction

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)1Permitted with supporting documentation.
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 · 33244

ICD lead extraction

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

33244 without 51 · national facility

$766.55

ICD lead extraction

33244-51 · Second procedure: 50%

$383.28

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

33244 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 33244

    ICD lead extraction13.4 wRVU

    Not priced

  • 33243

    ICD lead removal22.98 wRVU

    Not priced

  • 33235

    Pacemaker lead removal9.65 wRVU

    Not priced

  • 33241

    ICD generator removal2.96 wRVU

    Not priced

How to choose

33243ICD lead removal
Both concern removal of ICD leads, but the approach determines the code: 33244 is transvenous, while 33243 uses a thoracotomy.
33235Pacemaker lead removal
33235 applies to pacemaker electrodes in a multiple-lead system. 33244 applies to ICD lead extraction through the venous system.
33241ICD generator removal
33241 reports removal of the ICD pulse generator; 33244 reports extraction of ICD leads. A session may involve both distinct services.

Codes related to 33244

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

Codes related to 33244
CodeHow it relatesNational office range
Often billed with
33241ICD generator removalIdentifies removal of the ICD pulse generator when it is also removed during the session.No office rate
33249Defibrillator implantMay describe ICD system implantation or replacement performed during the same session.No office rate
Used instead
33243ICD lead removalFor ICD lead removal by thoracotomy rather than through the venous system.No office rate
33235Pacemaker lead removalFor transvenous removal of pacemaker electrodes in a multiple-lead system.No office rate

33244 billing questions

How does 33244 differ from 33243?

33244 is for ICD lead extraction through the venous system. Use 33243 when ICD lead removal is performed through a thoracotomy.

How does 33244 differ from 33235?

The device type distinguishes them: 33244 describes transvenous extraction of ICD leads, while 33235 describes transvenous removal of pacemaker electrodes in a multiple-lead system.

Can ICD generator removal be reported in the same session?

Report 33241 for removal of the ICD pulse generator when that separate service is performed. The record should support both generator removal and lead extraction.

Can a new ICD system be reported with 33244?

When an ICD system is implanted or replaced during the same session, 33249 may be reported for that service when its requirements are met.

Which modifiers and payment rules matter?

Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is not permitted.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, Medicare pays the highest-valued procedure in full and reduces the other procedures to 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 33244PPRRVU2026_Oct_nonQPP.csv, line 3,872 (RVU26D)

Open CMS sourceHow we calculate rates

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