No office rate
33206 describes an atrial single-chamber pacemaker. Choose 33208 when the implanted system has both atrial and ventricular transvenous leads.
On this page
CMS RVU26D · Effective 2026-10-01
33208 in Chico
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$441.29
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.
Cardiology procedure
About 33208: Dual-chamber transvenous pacemaker implantation
Implantation of a permanent dual-chamber pacemaker with transvenous atrial and ventricular leads when pacing support is needed in both chambers.
This service covers placement of a permanent dual-chamber transvenous pacemaker: one lead is positioned in the right atrium and another in the right ventricle, then connected to a pulse generator placed in a pocket. Electrophysiologists and cardiologists typically perform the procedure in a hospital electrophysiology laboratory or a comparable procedural setting for patients needing pacing in both chambers.
Report the code once for the dual-chamber system, not separately for each lead. The operative report should support the indication, lead locations, generator placement, and system configuration. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the global period. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant-at-surgery claim for this service. Co-surgeons are permitted; team-surgery billing is not permitted.
CMS billing rules for 33208
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.31 · 61%
- Practice expense (office) RVU3.39 · 25%
- Malpractice RVU1.95 · 14%
89.9K
Medicare services in 2024 · #593 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.
33208 compared with similar codes
Office rates for Chico, from the same CMS release.
No office rate
33207 describes a ventricular single-chamber pacemaker. Choose 33208 when both atrial and ventricular chambers are included in the implanted system.
No office rate
33213 covers pulse-generator insertion or replacement for a dual-lead system. It is not the complete dual-chamber implant represented by 33208.
No office rate
33214 describes upgrading an existing pacemaker system. Use 33208 for implantation of a new dual-chamber transvenous system.
The same code, a different location
How does Chico compare?
33208 across payment areas
Same release and payment basis · bars start at $0
Chico · 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.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California 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
Merced
California · 33208
Office
Unavailable
Facility
$441.29
No comparable office rate is available.
Modesto
California · 33208
Office
Unavailable
Facility
$441.29
No comparable office rate is available.
Napa
California · 33208
Office
Unavailable
Facility
$477.37
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 33208
Office
Unavailable
Facility
$459.75
No comparable office rate is available.
Redding
California · 33208
Office
Unavailable
Facility
$441.29
No comparable office rate is available.
Rest Of California
California · 33208
Office
Unavailable
Facility
$441.29
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 33208
Office
Unavailable
Facility
$462.21
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 33208
Office
Unavailable
Facility
$454.15
No comparable office rate is available.
Salinas
California · 33208
Office
Unavailable
Facility
$452.31
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 33208
Office
Unavailable
Facility
$456.61
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 33208
Office
Unavailable
Facility
$493.48
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 33208
Office
Unavailable
Facility
$491.26
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 33208
Office
Unavailable
Facility
$506.28
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 33208
Office
Unavailable
Facility
$497.23
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 33208
Office
Unavailable
Facility
$446.16
No comparable office rate is available.
Santa Cruz-Watsonville
California · 33208
Office
Unavailable
Facility
$455.87
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 33208
Office
Unavailable
Facility
$452.27
No comparable office rate is available.
Santa Rosa-Petaluma
California · 33208
Office
Unavailable
Facility
$459.84
No comparable office rate is available.
Stockton
California · 33208
Office
Unavailable
Facility
$441.29
No comparable office rate is available.
Vallejo
California · 33208
Office
Unavailable
Facility
$474.18
No comparable office rate is available.
Visalia
California · 33208
Office
Unavailable
Facility
$441.29
No comparable office rate is available.
Yuba City
California · 33208
Office
Unavailable
Facility
$441.29
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 33208
Office
Unavailable
Facility
$498.43
No comparable office rate is available.
Miami
Florida · 33208
Office
Unavailable
Facility
$560.15
No comparable office rate is available.
Chicago
Illinois · 33208
Office
Unavailable
Facility
$542.78
No comparable office rate is available.
Manhattan
New York · 33208
Office
Unavailable
Facility
$530.20
No comparable office rate is available.
Alaska*
Alaska · 33208
Office
Unavailable
Facility
$572.82
No comparable office rate is available.
Alabama
Alabama · 33208
Office
Unavailable
Facility
$413.50
No comparable office rate is available.
Arkansas
Arkansas · 33208
Office
Unavailable
Facility
$408.37
No comparable office rate is available.
Arizona
Arizona · 33208
Office
Unavailable
Facility
$443.03
No comparable office rate is available.
Colorado
Colorado · 33208
Office
Unavailable
Facility
$452.24
No comparable office rate is available.
Connecticut
Connecticut · 33208
Office
Unavailable
Facility
$483.87
No comparable office rate is available.
Delaware
Delaware · 33208
Office
Unavailable
Facility
$449.37
No comparable office rate is available.
Fort Lauderdale
Florida · 33208
Office
Unavailable
Facility
$510.02
No comparable office rate is available.
Rest Of Florida
Florida · 33208
Office
Unavailable
Facility
$483.70
No comparable office rate is available.
Atlanta
Georgia · 33208
Office
Unavailable
Facility
$471.66
No comparable office rate is available.
Rest Of Georgia
Georgia · 33208
Office
Unavailable
Facility
$456.20
No comparable office rate is available.
Hawaii, Guam
Hawaii · 33208
Office
Unavailable
Facility
$444.01
No comparable office rate is available.
Iowa
Iowa · 33208
Office
Unavailable
Facility
$407.02
No comparable office rate is available.
Idaho
Idaho · 33208
Office
Unavailable
Facility
$412.54
No comparable office rate is available.
East St. Louis
Illinois · 33208
Office
Unavailable
Facility
$512.91
No comparable office rate is available.
Rest Of Illinois
Illinois · 33208
Office
Unavailable
Facility
$482.74
No comparable office rate is available.
Suburban Chicago
Illinois · 33208
Office
Unavailable
Facility
$511.20
No comparable office rate is available.
Indiana
Indiana · 33208
Office
Unavailable
Facility
$414.18
No comparable office rate is available.
Kansas
Kansas · 33208
Office
Unavailable
Facility
$412.75
No comparable office rate is available.
Kentucky
Kentucky · 33208
Office
Unavailable
Facility
$437.82
No comparable office rate is available.
New Orleans
Louisiana · 33208
Office
Unavailable
Facility
$458.10
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 33208
Office
Unavailable
Facility
$440.17
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 33208
Office
Unavailable
Facility
$482.10
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 33208
Office
Unavailable
Facility
$453.14
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 33208
Office
Unavailable
Facility
$484.07
No comparable office rate is available.
Rest Of Maryland
Maryland · 33208
Office
Unavailable
Facility
$454.72
No comparable office rate is available.
Rest Of Maine
Maine · 33208
Office
Unavailable
Facility
$422.24
No comparable office rate is available.
Southern Maine
Maine · 33208
Office
Unavailable
Facility
$430.87
No comparable office rate is available.
Detroit
Michigan · 33208
Office
Unavailable
Facility
$496.64
No comparable office rate is available.
Rest Of Michigan
Michigan · 33208
Office
Unavailable
Facility
$454.47
No comparable office rate is available.
Minnesota
Minnesota · 33208
Office
Unavailable
Facility
$413.35
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 33208
Office
Unavailable
Facility
$447.52
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 33208
Office
Unavailable
Facility
$450.62
No comparable office rate is available.
Rest Of Missouri
Missouri · 33208
Office
Unavailable
Facility
$438.60
No comparable office rate is available.
Mississippi
Mississippi · 33208
Office
Unavailable
Facility
$423.18
No comparable office rate is available.
Montana**
Montana · 33208
Office
Unavailable
Facility
$455.79
No comparable office rate is available.
North Carolina
North Carolina · 33208
Office
Unavailable
Facility
$424.82
No comparable office rate is available.
North Dakota**
North Dakota · 33208
Office
Unavailable
Facility
$417.23
No comparable office rate is available.
Nebraska
Nebraska · 33208
Office
Unavailable
Facility
$406.69
No comparable office rate is available.
New Hampshire
New Hampshire · 33208
Office
Unavailable
Facility
$452.42
No comparable office rate is available.
Northern Nj
New Jersey · 33208
Office
Unavailable
Facility
$495.95
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 33208
Office
Unavailable
Facility
$483.76
No comparable office rate is available.
New Mexico
New Mexico · 33208
Office
Unavailable
Facility
$459.62
No comparable office rate is available.
Nevada**
Nevada · 33208
Office
Unavailable
Facility
$445.16
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 33208
Office
Unavailable
Facility
$550.90
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 33208
Office
Unavailable
Facility
$492.85
No comparable office rate is available.
Queens
New York · 33208
Office
Unavailable
Facility
$523.08
No comparable office rate is available.
Rest Of New York
New York · 33208
Office
Unavailable
Facility
$430.92
No comparable office rate is available.
Ohio
Ohio · 33208
Office
Unavailable
Facility
$446.59
No comparable office rate is available.
Oklahoma
Oklahoma · 33208
Office
Unavailable
Facility
$429.28
No comparable office rate is available.
Portland
Oregon · 33208
Office
Unavailable
Facility
$456.26
No comparable office rate is available.
Rest Of Oregon
Oregon · 33208
Office
Unavailable
Facility
$436.13
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 33208
Office
Unavailable
Facility
$478.13
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 33208
Office
Unavailable
Facility
$443.06
No comparable office rate is available.
Puerto Rico
Puerto Rico · 33208
Office
Unavailable
Facility
$456.19
No comparable office rate is available.
Rhode Island
Rhode Island · 33208
Office
Unavailable
Facility
$457.90
No comparable office rate is available.
South Carolina
South Carolina · 33208
Office
Unavailable
Facility
$437.55
No comparable office rate is available.
South Dakota**
South Dakota · 33208
Office
Unavailable
Facility
$412.67
No comparable office rate is available.
Tennessee
Tennessee · 33208
Office
Unavailable
Facility
$415.46
No comparable office rate is available.
Austin
Texas · 33208
Office
Unavailable
Facility
$455.62
No comparable office rate is available.
Beaumont
Texas · 33208
Office
Unavailable
Facility
$441.11
No comparable office rate is available.
Brazoria
Texas · 33208
Office
Unavailable
Facility
$442.79
No comparable office rate is available.
Dallas
Texas · 33208
Office
Unavailable
Facility
$448.72
No comparable office rate is available.
Fort Worth
Texas · 33208
Office
Unavailable
Facility
$448.43
No comparable office rate is available.
Galveston
Texas · 33208
Office
Unavailable
Facility
$446.15
No comparable office rate is available.
Houston
Texas · 33208
Office
Unavailable
Facility
$481.84
No comparable office rate is available.
Rest Of Texas
Texas · 33208
Office
Unavailable
Facility
$443.83
No comparable office rate is available.
Utah
Utah · 33208
Office
Unavailable
Facility
$442.49
No comparable office rate is available.
Virginia
Virginia · 33208
Office
Unavailable
Facility
$434.85
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 33208
Office
Unavailable
Facility
$456.19
No comparable office rate is available.
Vermont
Vermont · 33208
Office
Unavailable
Facility
$422.61
No comparable office rate is available.
Rest Of Washington
Washington · 33208
Office
Unavailable
Facility
$449.97
No comparable office rate is available.
Seattle (King Cnty)
Washington · 33208
Office
Unavailable
Facility
$483.58
No comparable office rate is available.
Wisconsin
Wisconsin · 33208
Office
Unavailable
Facility
$406.10
No comparable office rate is available.
West Virginia
West Virginia · 33208
Office
Unavailable
Facility
$469.16
No comparable office rate is available.
Wyoming**
Wyoming · 33208
Office
Unavailable
Facility
$438.99
No comparable office rate is available.
See how rates vary across the country
33208 · 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?
Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, 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 33208 in Chico. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$485.42
$441.29 × 110% = $485.42
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 33208 in Chico.
PPRRVU2026_Oct_nonQPP.csv
3,837
- Code
- 33208
- Physician work
- 8.31
- Practice expense
- 3.39
- Malpractice
- 1.95
GPCI2026.csv
9
- Locality
- Chico
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.31 | × 1.017 | 8.4513 |
| Practice expense | 3.39 | × 1.096 | 3.7154 |
| Malpractice | 1.95 | × 0.536 | 1.0452 |
| Total RVUs | 13.2119 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Chico$441.29
Open 33208 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.31 | 1.017 |
| Practice expense | 3.39 | 1.096 |
| Malpractice | 1.95 | 0.536 |
(8.31 × 1.017 + 3.39 × 1.096 + 1.95 × 0.536) × $33.4009 = $441.29
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
33208 · 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 | $441.29 | RVU26D |
| 2026-07-01 | Not available in this setting | $441.29 | RVU26C |
| 2026-04-01 | Not available in this setting | $441.29 | RVU26B |
| 2026-01-01 | Not available in this setting | $441.29 | RVU26A |
| 2025-10-01 | Not available in this setting | $486.23 | RVU25D |
| 2025-07-01 | Not available in this setting | $486.23 | RVU25C |
| 2025-04-01 | Not available in this setting | $486.23 | RVU25B |
| 2025-01-01 | Not available in this setting | $486.23 | RVU25A |
33208 billing questions
How does 33208 differ from 33206 or 33207?
Use 33208 for a dual-chamber system with both atrial and ventricular transvenous leads. Codes 33206 and 33207 describe single-chamber systems.
Should the leads and generator be billed separately?
For a complete dual-chamber implant, report 33208 once rather than billing separate lines for its atrial lead, ventricular lead, and generator.
When is 33213 used instead?
33213 is for insertion or replacement of a pulse generator in a dual-lead system without the complete lead-and-generator implantation represented by 33208.
How many units should be reported?
Report one unit for the dual-chamber system, not one unit for each transvenous lead.
How are assistant and co-surgeon claims handled?
Medicare does not pay an assistant-at-surgery claim for 33208. Co-surgeons are permitted when the operative circumstances support their separate roles; team-surgery billing is not permitted.
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.
3,83433203,,Insert epicard eltrd endo,A,,13.62,6.04,NA,6.04,,3.43,23.09,23.09,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,83533206,,Insert heart pm atrial,A,,6.96,3.45,NA,3.45,,1.63,12.04,12.04,0,090,0.09,0.84,0.07,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,83633207,,Insert heart pm ventricular,A,,7.61,3.25,NA,3.25,,1.78,12.64,12.64,0,090,0.09,0.84,0.07,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,83733208,,Insrt heart pm atrial & vent,A,,8.31,3.39,NA,3.39,,1.95,13.65,13.65,0,090,0.09,0.84,0.07,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8383320F,,No xray/ct/ et al ordd,M,,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
3,83933210,,Insert electrd/pm cath sngl,A,,2.97,0.59,NA,0.59,,0.65,4.21,4.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,84033211,,Insert card electrodes dual,A,,3.06,0.63,NA,0.63,,0.67,4.36,4.36,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536