No office rate
33234 is for transvenous removal of a pacemaker electrode in a single-lead system. Use 33238 for the thoracotomy-based removal service.
On this page
CMS RVU26D · Effective 2026-10-01
33238 in Beaumont
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$900.31
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Cardiac device surgery
About 33238: Epicardial pacing lead removal by thoracotomy
Reports surgical removal of a permanent pacing electrode through a thoracotomy, rather than extraction of a pacemaker lead through the venous route.
This service removes a permanent pacemaker electrode through an open chest approach. It is generally performed by a cardiac surgeon when the lead is accessible from the chest or cannot be removed using a transvenous extraction approach. The work concerns the pacing electrode, not simply removal of the pulse generator. The procedure is typically performed in a hospital operating room.
Report 33238 when the documented lead-removal procedure matches this thoracotomy-based service; distinguish it from transvenous pacemaker lead extraction and from removal of implantable defibrillator electrodes. The operative report should identify the device and electrode removed, the surgical approach, and the reason for removal. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is not appropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons are permitted, while team surgery is not permitted.
CMS billing rules for 33238
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.02 · 54%
- Practice expense (office) RVU9.44 · 34%
- Malpractice RVU3.60 · 13%
62
Medicare services in 2024 · #5220 by national volume
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.
33238 compared with similar codes
Office rates for Beaumont, from the same CMS release.
No office rate
33235 describes transvenous pacemaker electrode removal in a dual-lead system; 33238 describes removal through a thoracotomy.
No office rate
33243 is for thoracotomy-based removal of implantable defibrillator electrode(s). 33238 is the related pacing-electrode service.
No office rate
33244 removes implantable defibrillator electrode(s) transvenously. The device type and surgical approach distinguish it from 33238.
The same code, a different location
How does Beaumont compare?
33238 across payment areas
Same release and payment basis · bars start at $0
Beaumont · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 33238
Office
Unavailable
Facility
$909.49
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 33238
Office
Unavailable
Facility
$975.10
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 33238
Office
Unavailable
Facility
$1034.03
No comparable office rate is available.
Miami
Florida · 33238
Office
Unavailable
Facility
$1134.01
No comparable office rate is available.
Chicago
Illinois · 33238
Office
Unavailable
Facility
$1098.03
No comparable office rate is available.
Manhattan
New York · 33238
Office
Unavailable
Facility
$1090.88
No comparable office rate is available.
Alaska*
Alaska · 33238
Office
Unavailable
Facility
$1154.58
No comparable office rate is available.
Alabama
Alabama · 33238
Office
Unavailable
Facility
$845.63
No comparable office rate is available.
Arkansas
Arkansas · 33238
Office
Unavailable
Facility
$834.45
No comparable office rate is available.
Arizona
Arizona · 33238
Office
Unavailable
Facility
$910.14
No comparable office rate is available.
Bakersfield
California · 33238
Office
Unavailable
Facility
$930.02
No comparable office rate is available.
Chico
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
El Centro
California · 33238
Office
Unavailable
Facility
$920.84
No comparable office rate is available.
Fresno
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Hanford-Corcoran
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Madera
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Merced
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Modesto
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Napa
California · 33238
Office
Unavailable
Facility
$1009.94
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 33238
Office
Unavailable
Facility
$963.33
No comparable office rate is available.
Redding
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Rest Of California
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 33238
Office
Unavailable
Facility
$958.85
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 33238
Office
Unavailable
Facility
$950.89
No comparable office rate is available.
Salinas
California · 33238
Office
Unavailable
Facility
$947.12
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 33238
Office
Unavailable
Facility
$959.01
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 33238
Office
Unavailable
Facility
$1049.11
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 33238
Office
Unavailable
Facility
$1045.02
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 33238
Office
Unavailable
Facility
$1075.99
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 33238
Office
Unavailable
Facility
$1059.27
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 33238
Office
Unavailable
Facility
$933.79
No comparable office rate is available.
Santa Cruz-Watsonville
California · 33238
Office
Unavailable
Facility
$959.76
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 33238
Office
Unavailable
Facility
$947.82
No comparable office rate is available.
Santa Rosa-Petaluma
California · 33238
Office
Unavailable
Facility
$968.38
No comparable office rate is available.
Stockton
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Vallejo
California · 33238
Office
Unavailable
Facility
$1004.05
No comparable office rate is available.
Visalia
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Yuba City
California · 33238
Office
Unavailable
Facility
$920.23
No comparable office rate is available.
Colorado
Colorado · 33238
Office
Unavailable
Facility
$937.10
No comparable office rate is available.
Connecticut
Connecticut · 33238
Office
Unavailable
Facility
$996.79
No comparable office rate is available.
Delaware
Delaware · 33238
Office
Unavailable
Facility
$923.81
No comparable office rate is available.
Fort Lauderdale
Florida · 33238
Office
Unavailable
Facility
$1038.48
No comparable office rate is available.
Rest Of Florida
Florida · 33238
Office
Unavailable
Facility
$983.84
No comparable office rate is available.
Atlanta
Georgia · 33238
Office
Unavailable
Facility
$967.95
No comparable office rate is available.
Rest Of Georgia
Georgia · 33238
Office
Unavailable
Facility
$926.26
No comparable office rate is available.
Hawaii, Guam
Hawaii · 33238
Office
Unavailable
Facility
$929.80
No comparable office rate is available.
Iowa
Iowa · 33238
Office
Unavailable
Facility
$837.92
No comparable office rate is available.
Idaho
Idaho · 33238
Office
Unavailable
Facility
$848.64
No comparable office rate is available.
East St. Louis
Illinois · 33238
Office
Unavailable
Facility
$1033.93
No comparable office rate is available.
Rest Of Illinois
Illinois · 33238
Office
Unavailable
Facility
$977.49
No comparable office rate is available.
Suburban Chicago
Illinois · 33238
Office
Unavailable
Facility
$1042.08
No comparable office rate is available.
Indiana
Indiana · 33238
Office
Unavailable
Facility
$852.41
No comparable office rate is available.
Kansas
Kansas · 33238
Office
Unavailable
Facility
$847.32
No comparable office rate is available.
Kentucky
Kentucky · 33238
Office
Unavailable
Facility
$892.01
No comparable office rate is available.
New Orleans
Louisiana · 33238
Office
Unavailable
Facility
$934.98
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 33238
Office
Unavailable
Facility
$895.92
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 33238
Office
Unavailable
Facility
$1005.74
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 33238
Office
Unavailable
Facility
$937.56
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 33238
Office
Unavailable
Facility
$996.77
No comparable office rate is available.
Rest Of Maryland
Maryland · 33238
Office
Unavailable
Facility
$936.17
No comparable office rate is available.
Rest Of Maine
Maine · 33238
Office
Unavailable
Facility
$866.55
No comparable office rate is available.
Southern Maine
Maine · 33238
Office
Unavailable
Facility
$890.02
No comparable office rate is available.
Detroit
Michigan · 33238
Office
Unavailable
Facility
$1008.68
No comparable office rate is available.
Rest Of Michigan
Michigan · 33238
Office
Unavailable
Facility
$925.31
No comparable office rate is available.
Minnesota
Minnesota · 33238
Office
Unavailable
Facility
$861.72
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 33238
Office
Unavailable
Facility
$915.23
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 33238
Office
Unavailable
Facility
$922.34
No comparable office rate is available.
Rest Of Missouri
Missouri · 33238
Office
Unavailable
Facility
$890.59
No comparable office rate is available.
Mississippi
Mississippi · 33238
Office
Unavailable
Facility
$862.02
No comparable office rate is available.
Montana**
Montana · 33238
Office
Unavailable
Facility
$936.99
No comparable office rate is available.
North Carolina
North Carolina · 33238
Office
Unavailable
Facility
$872.70
No comparable office rate is available.
North Dakota**
North Dakota · 33238
Office
Unavailable
Facility
$865.80
No comparable office rate is available.
Nebraska
Nebraska · 33238
Office
Unavailable
Facility
$838.16
No comparable office rate is available.
New Hampshire
New Hampshire · 33238
Office
Unavailable
Facility
$935.13
No comparable office rate is available.
Northern Nj
New Jersey · 33238
Office
Unavailable
Facility
$1027.46
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 33238
Office
Unavailable
Facility
$997.97
No comparable office rate is available.
New Mexico
New Mexico · 33238
Office
Unavailable
Facility
$935.23
No comparable office rate is available.
Nevada**
Nevada · 33238
Office
Unavailable
Facility
$917.46
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 33238
Office
Unavailable
Facility
$1131.98
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 33238
Office
Unavailable
Facility
$1015.01
No comparable office rate is available.
Queens
New York · 33238
Office
Unavailable
Facility
$1079.87
No comparable office rate is available.
Rest Of New York
New York · 33238
Office
Unavailable
Facility
$885.75
No comparable office rate is available.
Ohio
Ohio · 33238
Office
Unavailable
Facility
$910.76
No comparable office rate is available.
Oklahoma
Oklahoma · 33238
Office
Unavailable
Facility
$876.68
No comparable office rate is available.
Portland
Oregon · 33238
Office
Unavailable
Facility
$949.47
No comparable office rate is available.
Rest Of Oregon
Oregon · 33238
Office
Unavailable
Facility
$900.26
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 33238
Office
Unavailable
Facility
$982.39
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 33238
Office
Unavailable
Facility
$904.76
No comparable office rate is available.
Puerto Rico
Puerto Rico · 33238
Office
Unavailable
Facility
$938.89
No comparable office rate is available.
Rhode Island
Rhode Island · 33238
Office
Unavailable
Facility
$944.18
No comparable office rate is available.
South Carolina
South Carolina · 33238
Office
Unavailable
Facility
$895.23
No comparable office rate is available.
South Dakota**
South Dakota · 33238
Office
Unavailable
Facility
$857.39
No comparable office rate is available.
Tennessee
Tennessee · 33238
Office
Unavailable
Facility
$852.86
No comparable office rate is available.
Utah
Utah · 33238
Office
Unavailable
Facility
$906.05
No comparable office rate is available.
Virginia
Virginia · 33238
Office
Unavailable
Facility
$896.52
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 33238
Office
Unavailable
Facility
$938.89
No comparable office rate is available.
Vermont
Vermont · 33238
Office
Unavailable
Facility
$874.68
No comparable office rate is available.
Rest Of Washington
Washington · 33238
Office
Unavailable
Facility
$931.72
No comparable office rate is available.
Seattle (King Cnty)
Washington · 33238
Office
Unavailable
Facility
$1011.88
No comparable office rate is available.
Wisconsin
Wisconsin · 33238
Office
Unavailable
Facility
$840.78
No comparable office rate is available.
West Virginia
West Virginia · 33238
Office
Unavailable
Facility
$947.75
No comparable office rate is available.
Wyoming**
Wyoming · 33238
Office
Unavailable
Facility
$905.97
No comparable office rate is available.
See how rates vary across the country
33238 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Beaumont is a Medicare payment area. Our Census mapping connects it to 13 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 33238 in Beaumont. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$990.34
$900.31 × 110% = $990.34
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33238 in Beaumont.
PPRRVU2026_Oct_nonQPP.csv
3,867
- Code
- 33238
- Physician work
- 15.02
- Practice expense
- 9.44
- Malpractice
- 3.60
GPCI2026.csv
97
- Locality
- Beaumont
- Physician work
- 1.000
- Practice expense
- 0.910
- Malpractice
- 0.929
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.02 | × 1.000 | 15.0200 |
| Practice expense | 9.44 | × 0.910 | 8.5904 |
| Malpractice | 3.60 | × 0.929 | 3.3444 |
| Total RVUs | 26.9548 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Beaumont$900.31
Open 33238 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.02 | 1 |
| Practice expense | 9.44 | 0.91 |
| Malpractice | 3.6 | 0.929 |
(15.02 × 1 + 9.44 × 0.91 + 3.6 × 0.929) × $33.4009 = $900.31
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
33238 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $900.31 | RVU26D |
| 2026-07-01 | Not available in this setting | $900.31 | RVU26C |
| 2026-04-01 | Not available in this setting | $900.31 | RVU26B |
| 2026-01-01 | Not available in this setting | $900.31 | RVU26A |
| 2025-10-01 | Not available in this setting | $876.46 | RVU25D |
| 2025-07-01 | Not available in this setting | $876.46 | RVU25C |
| 2025-04-01 | Not available in this setting | $876.46 | RVU25B |
| 2025-01-01 | Not available in this setting | $876.46 | RVU25A |
33238 billing questions
How does 33238 differ from transvenous pacemaker lead removal?
33238 describes removal through a thoracotomy. Codes 33234 and 33235 describe transvenous removal of pacemaker electrodes, with the applicable code depending on the lead system.
Is 33238 for the generator or the electrode?
It is for electrode removal. Do not use it for removal of a pulse generator alone.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this service; report the procedure without a bilateral adjustment.
When can an assistant surgeon be paid?
Assistant-at-surgery payment is available only when the record documents medical necessity for the assistant.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
Can co-surgeons report this procedure?
Co-surgeons are permitted. Team surgery is not permitted for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,86433235,,Removal pacemaker electrode,A,,9.65,5.07,NA,5.07,,2.28,17.00,17.00,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86533236,,Remove electrode/thoracotomy,A,,12.41,7.92,NA,7.92,,2.97,23.30,23.30,0,090,0.09,0.84,0.07,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86633237,,Remove electrode/thoracotomy,A,,13.49,8.15,NA,8.15,,3.22,24.86,24.86,0,090,0.09,0.84,0.07,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86733238,,Remove electrode/thoracotomy,A,,15.02,9.44,NA,9.44,,3.60,28.06,28.06,0,090,0.09,0.84,0.07,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8683323F,,Clin node stgng docdb/4 surg,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86933240,,Insrt pulse gen w/singl lead,A,,5.66,2.59,NA,2.59,,1.34,9.59,9.59,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87033241,,Remove pulse generator,A,,2.96,2.26,NA,2.26,,0.70,5.92,5.92,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858
10004412,TX,28,FORT WORTH,1.009,0.986,0.871