No office rate
Use 33222 for relocation of a pacemaker generator pocket; 33223 covers relocation of a defibrillator pocket.
On this page
CMS RVU26D · Effective 2026-10-01
33222 Pocket relocation Medicare reimbursement rates in Arkansas
Reports surgical relocation of an existing pacemaker generator into a different pocket, such as when the current pocket causes discomfort or threatens the overlying skin. Compare 33222 office and facility rates across CMS payment localities in Arkansas.
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.
What does Medicare pay for 33222 in Arkansas?
Arkansas has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$275.95
1 of 1 localities have a supported rate.
Payment area: Arkansas
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Cardiac device surgery
About 33222: Pacemaker Pocket Relocation
Reports surgical relocation of an existing pacemaker generator into a different pocket, such as when the current pocket causes discomfort or threatens the overlying skin.
The surgeon frees the existing pacemaker generator from its pocket and moves it into a newly created pocket at a different site. This procedure is typically performed by a cardiac electrophysiologist or cardiothoracic surgeon in a hospital operating room when the existing pocket’s position or condition requires relocation. The service addresses the generator pocket, not repositioning a pacing lead or implanting a new generator.
Report the procedure when the operative record supports relocation of the pacemaker pocket and generator; distinguish it from generator replacement or lead repositioning. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 33222
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.73 · 51%
- Practice expense (office) RVU3.44 · 37%
- Malpractice RVU1.12 · 12%
1.7K
Medicare services in 2024 · #2601 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.
33222 compared with similar codes
Office rates for Arkansas, from the same CMS release.
No office rate
33215 addresses repositioning a pacing-defibrillator lead. It does not describe moving the pacemaker generator to a new pocket.
No office rate
33228 covers replacement of a dual-lead pacemaker generator. Choose based on whether the documented work replaces the generator or relocates its pocket.
Compare 33222 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Arkansas →
Office / nonfacility
Unavailable
Facility
$275.95
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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 33222 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
3,851
- Code
- 33222
- Physician work
- 4.73
- Practice expense
- 3.44
- Malpractice
- 1.12
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.73 | × 1.000 | 4.7300 |
| Practice expense | 3.44 | × 0.859 | 2.9550 |
| Malpractice | 1.12 | × 0.515 | 0.5768 |
| Total RVUs | 8.2618 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$275.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.73 | 1 |
| Practice expense | 3.44 | 0.859 |
| Malpractice | 1.12 | 0.515 |
(4.73 × 1 + 3.44 × 0.859 + 1.12 × 0.515) × $33.4009 = $275.95
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.
33222 billing questions
How is this different from pacemaker lead repositioning?
33222 relocates the generator pocket. When the work repositions a pacing lead rather than the generator pocket, consider the lead-repositioning code 33215.
How does this differ from defibrillator pocket relocation?
33222 is for a pacemaker generator pocket. Code 33223 is the corresponding pocket-relocation code for a defibrillator.
Can this be reported when the generator is replaced?
The operative documentation should distinguish pocket relocation from generator replacement, such as 33228 for replacement of a dual-lead pacemaker generator. Do not treat replacement alone as pocket relocation.
Does modifier 50 apply?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
3,8483321F,,Ajcc cncr 0/ia melan docd,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
3,84933220,,Repair lead pace-defib dual,A,,5.75,3.11,NA,3.11,,1.36,10.22,10.22,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85033221,,Insert pulse gen mult leads,A,,5.41,2.84,NA,2.84,,1.29,9.54,9.54,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85133222,,Relocation pocket pacemaker,A,,4.73,3.44,NA,3.44,,1.12,9.29,9.29,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85233223,,Relocate pocket for defib,A,,6.14,3.32,NA,3.32,,1.44,10.90,10.90,0,090,0.09,0.84,0.07,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85333224,,Insert pacing lead & connect,A,,8.81,2.33,NA,2.33,,2.08,13.22,13.22,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85433225,,L ventric pacing lead add-on,A,,8.12,1.78,NA,1.78,,1.91,11.81,11.81,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
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