No office rate
33277 covers initial placement of a transvenous phrenic nerve stimulator lead. Choose 33281 when the procedure adjusts an existing lead's position.
On this page
CMS RVU26D · Effective 2026-10-01
33281 Lead repositioning Medicare reimbursement rates in Florida
Reports surgical repositioning of an implanted transvenous phrenic nerve stimulator lead when its position needs adjustment to support effective stimulation. Compare 33281 office and facility rates across CMS payment localities in Florida.
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 33281 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$357.96–$414.14
3 of 3 localities have a supported rate.
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 33281 pays more and less in Florida
Neurostimulator procedures
About 33281: Transvenous phrenic nerve lead repositioning
Reports surgical repositioning of an implanted transvenous phrenic nerve stimulator lead when its position needs adjustment to support effective stimulation.
Code 33281 describes an operation to adjust the position of an already implanted transvenous lead for a phrenic nerve stimulation system. The system is used to stimulate breathing, including in patients treated for central sleep apnea. A physician who manages implanted cardiac or neurostimulation devices, commonly an electrophysiologist, may perform the procedure in a hospital or other surgical setting when a lead has shifted or its position is not providing the intended stimulation.
Report this code for repositioning an existing lead, not its initial placement, removal alone, or removal and replacement. The operative record should identify the implanted lead and document the repositioning performed and its clinical purpose. The service has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery payment are not permitted.
CMS billing rules for 33281
- 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 RVU5.85 · 58%
- Practice expense (office) RVU2.89 · 29%
- Malpractice RVU1.40 · 14%
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.
33281 compared with similar codes
Office rates for Florida, from the same CMS release.
No office rate
33279 is for removing a transvenous phrenic nerve stimulator lead. It does not describe repositioning the lead.
No office rate
33288 covers removing and replacing a phrenic nerve stimulator lead. Use 33281 when the existing lead is repositioned rather than exchanged.
Compare 33281 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
Unavailable
Facility
$377.72
Miami →
Office / nonfacility
Unavailable
Facility
$414.14
Rest Of Florida →
Office / nonfacility
Unavailable
Facility
$357.96
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33281 billing questions
When should 33281 be reported instead of 33277?
Use 33281 when repositioning a previously implanted transvenous phrenic nerve stimulator lead. Code 33277 is for placing a transvenous lead.
Does 33281 include lead removal or replacement?
It describes repositioning an existing lead. Removal alone and removal with replacement are distinct procedures, represented by codes such as 33279 and 33288.
Can modifier 50 be used for repositioning leads on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be paid for this procedure?
Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted under the CMS rules provided 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.
3,90133278,,Rmvl phrnc nrv stim sys,A,,9.31,3.51,NA,3.51,,2.06,14.88,14.88,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90233279,,Rmvl phrnc nrv stim transvns,A,,5.28,2.67,NA,2.67,,1.29,9.24,9.24,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90333280,,Rmvl phrnc nrv stim pg only,A,,2.96,2.09,NA,2.09,,0.70,5.75,5.75,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90433281,,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