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Billing code 33287: Generator exchangeMedicare rate & RVUs

Report this code when a surgeon removes and replaces the pulse generator of an implanted phrenic nerve stimulation system, typically for battery depletion or generator failure.

CMS RVU26DEffective Oct 1, 2026109 payment localities36 Medicare services in 2024

Medicare pays $341.02 for 33287 nationally in a facility.

Medicare rate · 33287

Generator exchange

Work RVUs
5.9
Total RVUs
10.21
Global days
090

National rate · 2026

$341.02

Facility setting, before claim adjustments.

See every locality for 33287 →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 33287 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 33287 covers

This service removes an implanted phrenic nerve stimulator pulse generator and places a replacement, generally retaining the existing lead or leads. It is commonly performed by a cardiologist or electrophysiologist in a hospital or other surgical setting for a patient receiving phrenic nerve stimulation, such as treatment for central sleep apnea. A generator exchange may be needed when the battery is depleted or the generator has failed.

Report the code for the generator exchange, not for removal alone or for lead replacement. The operative report should document removal of the existing generator and placement of its replacement. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one 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 for this code. Medicare does not pay an assistant at surgery; 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 33287 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

33287 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$309.20
Alaska*Unavailable$425.91
ArizonaUnavailable$331.50
ArkansasUnavailable$305.33
AtlantaUnavailable$352.20
AustinUnavailable$342.07
BakersfieldUnavailable$336.79
Baltimore/Surr. CntysUnavailable$362.03
BeaumontUnavailable$328.92
BrazoriaUnavailable$331.86

33287 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
33287 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 33287 rate is calculated

Each of 33287’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 · 33287

RVUs × geographic indexes × conversion factor

Work5.90

5.90 RVUs× 1.000 GPCI

Practice expense2.97

2.97 RVUs× 1.000 GPCI

Malpractice1.34

1.34 RVUs× 1.000 GPCI

Adjusted RVUs

10.2100

Conversion factor

$33.4009

Medicare rate

$341.02

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

Payment rules and modifiers for 33287

33287 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33287

Generator exchange

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 · 33287

Generator exchange

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

33287 without 51 · national facility

$341.02

Generator exchange

33287-51 · Second procedure: 50%

$170.51

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

33287 compared with similar codes

Compare codes · National

4 codes, side by side

  • 33287

    Generator exchange5.9 wRVU

    Not priced

  • 33280

    Stimulator removal2.96 wRVU

    Not priced

  • 33288

    Lead exchange8.3 wRVU

    Not priced

  • 33276

    Phrenic stimulator implant9.26 wRVU

    Not priced

How to choose

33280Stimulator removal
33280 is for generator removal alone. Choose 33287 when the removed generator is replaced during the service.
33288Lead exchange
33288 describes removal and replacement of a lead, rather than the pulse generator. Distinguish the component exchanged in the operative report.
33276Phrenic stimulator implant
33276 is for insertion of a phrenic nerve stimulation system. 33287 is for exchanging the pulse generator in an existing system.

Codes related to 33287

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

Codes related to 33287
CodeHow it relatesNational office range
Same family
33280Stimulator removalRemoval of the phrenic nerve stimulator pulse generator without replacement.No office rate
33288Lead exchangeRemoval and replacement of a phrenic nerve stimulator lead.No office rate
33278Stimulator removalRemoval of the phrenic nerve stimulation system.No office rate
33279Lead removalRemoval of a phrenic nerve stimulator transvenous lead.No office rate
Used instead
33276Phrenic stimulator implantInsertion of a phrenic nerve stimulation system rather than exchange of its generator.No office rate

33287 billing questions

When should 33287 be chosen instead of 33280?

Use 33287 when the pulse generator is removed and a replacement generator is placed. Code 33280 describes removal of the generator without replacement.

Does 33287 include replacement of the phrenic nerve lead?

No. This code describes the pulse generator exchange. Lead removal and replacement is represented by 33288 when that service is performed.

Should modifier 50 be appended for a bilateral procedure?

No. Modifier 50 is inappropriate for this code based on its descriptor and anatomy.

What documentation supports reporting 33287?

Document removal of the existing phrenic nerve stimulator pulse generator and placement of the replacement generator. Include the reason for exchange, such as battery depletion or generator failure, when documented.

How does the 90-day global period affect follow-up billing?

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

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard 50% 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 33287PPRRVU2026_Oct_nonQPP.csv, line 3,907 (RVU26D)

Open CMS sourceHow we calculate rates

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