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Billing code 33270: Defibrillator implantMedicare rate & RVUs

Reports implantation or replacement of a complete subcutaneous implantable defibrillator system, including its electrode and intraoperative device testing.

CMS RVU26DEffective Oct 1, 2026109 payment localities757 Medicare services in 2024

Medicare pays $493.00 for 33270 nationally in a facility.

Medicare rate · 33270

Defibrillator implant

Swap in your local Medicare rate.

Work RVUs
8.87
Total RVUs
14.76
Global days
090

National rate · 2026

$493.00

Facility setting, before claim adjustments.

See every locality for 33270 → · 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 33270 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 33270 covers

This service covers placing or replacing a subcutaneous implantable cardioverter-defibrillator system, with the generator under the skin and an electrode positioned beneath the skin along the sternum. The physician also performs the system’s specified intraoperative testing, including arrhythmia induction and evaluation of defibrillation, sensing, or pacing function. Electrophysiologists and cardiac surgeons commonly perform the procedure in a hospital operating room or electrophysiology laboratory for patients who need protection from life-threatening ventricular arrhythmias and are receiving a subcutaneous rather than transvenous system.

Report 33270 for the complete system service, not when the work is limited to inserting an electrode. The operative report should identify whether the system was implanted or replaced, describe the subcutaneous generator and electrode placement, and document the testing performed. CMS assigns a 90-day global period; the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and 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 33270 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

33270 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$446.94
Alaska*Unavailable$618.21
ArizonaUnavailable$479.05
ArkansasUnavailable$441.36
AtlantaUnavailable$509.89
AustinUnavailable$493.05
BakersfieldUnavailable$483.68
Baltimore/Surr. CntysUnavailable$523.49
BeaumontUnavailable$476.61
BrazoriaUnavailable$478.94

33270 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
33270 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 33270 rate is calculated

Each of 33270’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 · 33270

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.87Practice expense 3.81Malpractice 2.08

14.7600 adjusted RVUs×$33.4009 conversion factor=$493.00

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

Payment rules and modifiers for 33270

33270 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33270

Defibrillator implant

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 · 33270

Defibrillator implant

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

33270 without 51 · national facility

$493.00

Defibrillator implant

33270-51 · Second procedure: 50%

$246.50

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

33270 compared with similar codes

Compare codes

33270 vs 33271 vs 33249 vs 33262 vs 33272: national Medicare rates

Swap in your local Medicare rate.

  • 33270
    Defibrillator implant · 8.87 wRVU
    —
  • 33271
    Defibrillator electrode · 7.31 wRVU
    —
  • 33249
    Defibrillator implant · 14.55 wRVU
    —
  • 33262
    Defibrillator exchange · 5.66 wRVU
    —
  • 33272
    Defibrillator removal · 5.28 wRVU
    —

How to choose

33271Defibrillator electrode
33271 covers insertion of the subcutaneous electrode alone; 33270 covers implantation or replacement of the complete system and includes the electrode.
33249Defibrillator implant
33249 applies to a defibrillator system with transvenous lead(s). Choose 33270 for the complete subcutaneous system.
33262Defibrillator exchange
33262 is generator removal and replacement for a single-lead transvenous defibrillator system. It is not the code for replacing a complete subcutaneous system.
33272Defibrillator removal
33272 describes removal of a subcutaneous defibrillator electrode, not implantation or replacement of the complete system.

Codes related to 33270

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

Codes related to 33270
CodeHow it relatesNational office range
Same family
33271Defibrillator electrodeElectrode insertion alone, rather than implantation or replacement of the complete system.No office rate
Used instead
33249Defibrillator implantFor an implantable defibrillator system using transvenous lead(s).No office rate
33262Defibrillator exchangeGenerator removal and replacement for a single-lead transvenous defibrillator system.No office rate

33270 billing questions

When should 33270 be chosen over 33271?

Use 33270 for implantation or replacement of the complete subcutaneous defibrillator system, including its electrode and specified testing. Code 33271 describes electrode insertion alone.

Can the electrode be reported separately with 33270?

The electrode is part of the complete system service described by 33270. Do not separately report 33271 for the electrode placement included in that service.

How does 33270 differ from 33249?

33270 is for a subcutaneous defibrillator system with an electrode positioned beneath the skin. 33249 is for an implantable defibrillator system using transvenous lead(s).

What postoperative care is included?

CMS assigns 33270 a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care.

Can modifier 50 or an assistant-at-surgery modifier be used?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for 33270.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50% when performed in the same session.

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 33270PPRRVU2026_Oct_nonQPP.csv, line 3,893 (RVU26D)

Open CMS sourceHow we calculate rates

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