No office rate
33280 is for generator removal alone. Choose 33287 when the removed generator is replaced during the service.
On this page
CMS RVU26D · Effective 2026-10-01
33287 Generator exchange Medicare reimbursement rates in California
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. Compare 33287 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 33287 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
$333.13–$385.78
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $52.65 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 33287 pays more and less in California
Neurostimulator surgery
About 33287: Phrenic nerve stimulator generator exchange
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.
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.
CMS billing rules for 33287
- 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 RVU5.90 · 58%
- Practice expense (office) RVU2.97 · 29%
- Malpractice RVU1.34 · 13%
36
Medicare services in 2024 · #5550 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.
33287 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
33288 describes removal and replacement of a lead, rather than the pulse generator. Distinguish the component exchanged in the operative report.
No office rate
33276 is for insertion of a phrenic nerve stimulation system. 33287 is for exchanging the pulse generator in an existing system.
Compare 33287 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 $336.79 |
| Chico | Office Unavailable | Facility $333.13 |
| El Centro | Office Unavailable | Facility $333.35 |
| Fresno | Office Unavailable | Facility $333.13 |
| Hanford-Corcoran | Office Unavailable | Facility $333.13 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $352.22 |
| Madera | Office Unavailable | Facility $333.13 |
| Merced | Office Unavailable | Facility $333.13 |
| Modesto | Office Unavailable | Facility $333.13 |
| Napa | Office Unavailable | Facility $362.96 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $347.72 |
| Redding | Office Unavailable | Facility $333.13 |
| Rest Of California | Office Unavailable | Facility $333.13 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $347.51 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $343.52 |
| Salinas | Office Unavailable | Facility $342.14 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $345.88 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $376.20 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $374.68 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $385.78 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $379.56 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $337.39 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $345.72 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $342.24 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $348.79 |
| Stockton | Office Unavailable | Facility $333.13 |
| Vallejo | Office Unavailable | Facility $360.77 |
| Visalia | Office Unavailable | Facility $333.13 |
| Yuba City | Office Unavailable | Facility $333.13 |
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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 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.
3,90433281,,Reposg phrnc nrv stim trnsvn,A,,5.85,2.89,NA,2.89,,1.40,10.14,10.14,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90533285,,Insj subq car rhythm mntr,A,,1.49,118.27,,0.42,,0.36,120.12,2.27,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90633286,,Rmvl subq car rhythm mntr,A,,1.46,2.04,,0.42,,0.36,3.86,2.24,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90733287,,Rmv&rplcmt phrnc nrv stim pg,A,,5.90,2.97,NA,2.97,,1.34,10.21,10.21,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90833288,,Rmv&rplcmt phrnc nrv stim ld,A,,8.30,3.52,NA,3.52,,1.84,13.66,13.66,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90933289,,Tcat impl wrls p-art prs snr,A,,5.85,1.47,NA,1.47,,1.19,8.51,8.51,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,9103328F,,Prfrmnc docd 2 wks b/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