No office rate
Use 33227 for generator replacement in a single-lead pacemaker system; this code is for a multiple-lead system.
On this page
CMS RVU26D · Effective 2026-10-01
33229 Pacemaker replacement Medicare reimbursement rates in California
Reports removal and replacement of a pacemaker pulse generator connected to a multiple-lead system, such as a pacemaker requiring generator exchange. Compare 33229 office and facility rates across CMS payment localities in California.
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 33229 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$321.53–$372.48
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $50.95 per service.
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.
Where 33229 pays more and less in California
Cardiology procedure
About 33229: Multilead pacemaker generator replacement
Reports removal and replacement of a pacemaker pulse generator connected to a multiple-lead system, such as a pacemaker requiring generator exchange.
During this procedure, the clinician opens the pacemaker pocket, disconnects and removes the existing pulse generator, and connects a replacement generator to the existing multiple-lead system. It is commonly performed by an electrophysiologist or other cardiac device specialist when a pacemaker generator reaches its replacement threshold, including because of battery depletion. The procedure may take place in a hospital or an ambulatory setting.
Select this code for a generator exchange in a multiple-lead pacemaker system; the number and type of leads, not the reason for replacement, distinguish it from single- and dual-lead generator replacement codes. The operative report should support removal of the old generator, placement of the replacement, and the multiple-lead system involved. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 33229
- 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 RVU5.65 · 57%
- Practice expense (office) RVU2.89 · 29%
- Malpractice RVU1.33 · 13%
6.8K
Medicare services in 2024 · #1677 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.
33229 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
Use 33228 for a dual-lead system. This code applies when the pacemaker system has multiple leads.
No office rate
33231 describes generator insertion with a multiple-lead system. This code describes removing an existing generator and replacing it.
No office rate
33264 is for ICD generator removal and replacement in a multiple-lead system; this code is for a pacemaker generator.
Compare 33229 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $325.15 |
| Chico | Office Unavailable | Facility $321.53 |
| El Centro | Office Unavailable | Facility $321.75 |
| Fresno | Office Unavailable | Facility $321.53 |
| Hanford-Corcoran | Office Unavailable | Facility $321.53 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $340.14 |
| Madera | Office Unavailable | Facility $321.53 |
| Merced | Office Unavailable | Facility $321.53 |
| Modesto | Office Unavailable | Facility $321.53 |
| Napa | Office Unavailable | Facility $350.40 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $335.77 |
| Redding | Office Unavailable | Facility $321.53 |
| Rest Of California | Office Unavailable | Facility $321.53 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $335.80 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $331.58 |
| Salinas | Office Unavailable | Facility $330.25 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $333.90 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $363.14 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $361.63 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $372.48 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $366.30 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $325.68 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $333.77 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $330.36 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $336.72 |
| Stockton | Office Unavailable | Facility $321.53 |
| Vallejo | Office Unavailable | Facility $348.22 |
| Visalia | Office Unavailable | Facility $321.53 |
| Yuba City | Office Unavailable | Facility $321.53 |
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33229 billing questions
How is this code distinguished from the single- and dual-lead replacement codes?
Choose based on the pacemaker system’s lead configuration: this code is for a multiple-lead system, while 33227 and 33228 represent single- and dual-lead systems.
Does this code include replacement of the pacing leads?
It describes exchange of the pulse generator connected to the existing multiple-lead system. Lead insertion, repositioning, or repair is a different service and should be supported and coded separately when performed.
Can this code be used for an ICD generator exchange?
No. This code is for a pacemaker generator; an ICD generator replacement belongs to the ICD procedure code family.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How does Medicare handle another procedure 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.
Can an assistant or co-surgeon be reported for this procedure?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are 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.
3,85533226,,Reposition l ventric lead,A,,8.46,2.20,NA,2.20,,2.01,12.67,12.67,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85633227,,Remove&replace pm gen singl,A,,5.12,2.71,NA,2.71,,1.21,9.04,9.04,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85733228,,Remv&replc pm gen dual lead,A,,5.38,2.78,NA,2.78,,1.28,9.44,9.44,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85833229,,Remv&replc pm gen mult leads,A,,5.65,2.89,NA,2.89,,1.33,9.87,9.87,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8593322F,,Melanomaajcc stage 0 or ia,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
3,86033230,,Insrt pulse gen w/dual leads,A,,5.92,2.64,NA,2.64,,1.41,9.97,9.97,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86133231,,Insrt pulse gen w/mult leads,A,,6.18,3.00,NA,3.00,,1.45,10.63,10.63,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00