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CPT code 33276: Phrenic stimulator implant2026 Medicare rate & RVUs

Reports implantation of a complete phrenic nerve stimulation system, including transvenous lead or leads and a pulse generator, for conditions such as central sleep apnea.

CMS RVU26DEffective Oct 1, 2026109 payment localities154 Medicare services in 2024

Medicare pays $505.36 for 33276 nationally in a facility.

Medicare rate · 33276

Phrenic stimulator implant

Work RVUs
9.26
Total RVUs
15.13
Global days
090

National rate · 2026

$505.36

Facility setting, before claim adjustments.

See every locality for 33276 →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 33276 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 33276 covers

This code describes implantation of a complete phrenic nerve stimulation system: transvenous lead or leads and the pulse generator. The system is used to stimulate the phrenic nerve, commonly as treatment for central sleep apnea. An electrophysiologist or another appropriately trained implanting physician typically performs the procedure in a hospital operating room or cardiac catheterization lab.

Report 33276 when the operative record supports placement of the complete system, rather than lead-only insertion or a component removal or replacement. Documentation should identify the indication and the components implanted. The code has a 90-day global period, which includes the related preoperative visit on the preceding day and related postoperative care for 90 days. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 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 33276 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

33276 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$459.07
Alaska*Unavailable$636.52
ArizonaUnavailable$491.31
ArkansasUnavailable$453.47
AtlantaUnavailable$522.46
AustinUnavailable$505.22
BakersfieldUnavailable$495.73
Baltimore/Surr. CntysUnavailable$536.17
BeaumontUnavailable$489.05
BrazoriaUnavailable$491.19

33276 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
33276 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 33276 rate is calculated

Each of 33276’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 · 33276

RVUs × geographic indexes × conversion factor

Work9.26

9.26 RVUs× 1.000 GPCI

Practice expense3.76

3.76 RVUs× 1.000 GPCI

Malpractice2.11

2.11 RVUs× 1.000 GPCI

Adjusted RVUs

15.1300

Conversion factor

$33.4009

Medicare rate

$505.36

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

Payment rules and modifiers for 33276

33276 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33276

Phrenic stimulator 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 · 33276

Phrenic stimulator 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.

  • 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

33276 without 51 · national facility

$505.36

Phrenic stimulator implant

33276-51 · Second procedure: 50%

$252.68

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

33276 compared with similar codes

Compare codes · National

5 codes, side by side

  • 33276

    Phrenic stimulator implant9.26 wRVU

    Not priced

  • 33277

    Phrenic stimulator lead5.29 wRVU

    Not priced

  • 33278

    Stimulator removal9.31 wRVU

    Not priced

  • 33287

    Generator exchange5.9 wRVU

    Not priced

  • 33288

    Lead exchange8.3 wRVU

    Not priced

How to choose

33277Phrenic stimulator lead
33276 covers implantation of the complete system, including the pulse generator. 33277 covers transvenous lead insertion without the generator.
33278Stimulator removal
33276 is for implanting a complete system; 33278 is for removing a complete phrenic nerve stimulation system.
33287Generator exchange
33276 describes initial implantation of the complete system. 33287 describes removing and replacing the pulse generator in an existing system.
33288Lead exchange
33276 describes implantation of the complete system. 33288 describes removal and replacement of a phrenic stimulator lead.

Codes related to 33276

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

Codes related to 33276
CodeHow it relatesNational office range
Used instead
33277Phrenic stimulator leadFor insertion of transvenous phrenic stimulator lead or leads without the pulse generator.No office rate
Same family
33278Stimulator removalPhrenic stimulator series code for removal of the complete system.No office rate
33279Lead removalPhrenic stimulator series code for removal of transvenous lead or leads.No office rate
33280Stimulator removalPhrenic stimulator series code for removal of the pulse generator alone.No office rate
33287Generator exchangePhrenic stimulator series code for pulse-generator removal and replacement.No office rate
33288Lead exchangePhrenic stimulator series code for lead removal and replacement.No office rate

33276 billing questions

When should 33276 be used instead of 33277?

Use 33276 when the complete system, including transvenous lead or leads and the pulse generator, is implanted. Code 33277 is for transvenous lead insertion without the pulse generator.

Are the leads and pulse generator reported separately?

The complete-system insertion is reported with 33276 when both the lead or leads and pulse generator are implanted. The operative documentation should identify the components placed.

Can modifier 50 be reported?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

Is an assistant surgeon payable for this procedure?

No. CMS lists a statutory restriction on assistant-at-surgery payment for 33276. Co-surgeons and team surgery are also not permitted.

What postoperative care is included in the global period?

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

How are other procedures handled when performed in the same session?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction.

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 33276PPRRVU2026_Oct_nonQPP.csv, line 3,899 (RVU26D)

Open CMS sourceHow we calculate rates

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