Billing code 33244: ICD lead extractionMedicare rate & RVUs in Guam
Removal of an implantable cardioverter-defibrillator lead through the venous system, typically for infection, malfunction, or system revision.
CMS doesn’t publish an office rate for 33244 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 33244 covers
This service removes one or more implantable cardioverter-defibrillator (ICD) leads through the venous system. The physician may use specialized extraction sheaths and related tools to free leads from scar tissue. Electrophysiologists commonly perform the procedure in a hospital electrophysiology laboratory or operating room, often with surgical support available because extraction can carry serious risks. The code is for ICD leads, not pacemaker leads, and the approach is transvenous rather than through a thoracotomy.
Select the code when the record supports extraction of an ICD lead by the transvenous route. Document the device and lead type, the extraction approach, and the work performed; report separate generator removal when that service is also performed. The 90-day global period includes the day-before preoperative visit and related postoperative care. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment is restricted by statute; co-surgeons require supporting documentation, and team surgery is not permitted.
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.
33244 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $750.98 |
How the 33244 rate is calculated
Each of 33244’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 33244
RVUs × geographic indexes × conversion factor
Work13.40
13.40 RVUs× 1.000 GPCI
Practice expense6.37
6.37 RVUs× 1.000 GPCI
Malpractice3.18
3.18 RVUs× 1.000 GPCI
Adjusted RVUs
22.9500
Conversion factor
$33.4009
Medicare rate
$766.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33244
33244 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33244
ICD lead extraction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33244
ICD lead extraction
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33244 without 51 · national facility
$766.55
ICD lead extraction
33244-51 · Second procedure: 50%
$383.28
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
33244 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33243ICD lead removal
- Both concern removal of ICD leads, but the approach determines the code: 33244 is transvenous, while 33243 uses a thoracotomy.
- 33235Pacemaker lead removal
- 33235 applies to pacemaker electrodes in a multiple-lead system. 33244 applies to ICD lead extraction through the venous system.
- 33241ICD generator removal
- 33241 reports removal of the ICD pulse generator; 33244 reports extraction of ICD leads. A session may involve both distinct services.
33244 billing questions
How does 33244 differ from 33243?
33244 is for ICD lead extraction through the venous system. Use 33243 when ICD lead removal is performed through a thoracotomy.
How does 33244 differ from 33235?
The device type distinguishes them: 33244 describes transvenous extraction of ICD leads, while 33235 describes transvenous removal of pacemaker electrodes in a multiple-lead system.
Can ICD generator removal be reported in the same session?
Report 33241 for removal of the ICD pulse generator when that separate service is performed. The record should support both generator removal and lead extraction.
Can a new ICD system be reported with 33244?
When an ICD system is implanted or replaced during the same session, 33249 may be reported for that service when its requirements are met.
Which modifiers and payment rules matter?
Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, Medicare pays the highest-valued procedure in full and reduces the other procedures to 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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