No office rate
Both concern removal of ICD leads, but the approach determines the code: 33244 is transvenous, while 33243 uses a thoracotomy.
On this page
CMS RVU26D · Effective 2026-10-01
33244 ICD lead extraction Medicare reimbursement rates in Hawaii
Removal of an implantable cardioverter-defibrillator lead through the venous system, typically for infection, malfunction, or system revision. Compare 33244 office and facility rates across CMS payment localities in Hawaii.
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 33244 in Hawaii?
Hawaii 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
$750.98
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 33244: Transvenous ICD lead extraction
Removal of an implantable cardioverter-defibrillator lead through the venous system, typically for infection, malfunction, or system revision.
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.
CMS billing rules for 33244
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.40 · 58%
- Practice expense (office) RVU6.37 · 28%
- Malpractice RVU3.18 · 14%
3K
Medicare services in 2024 · #2170 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.
33244 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
33235 applies to pacemaker electrodes in a multiple-lead system. 33244 applies to ICD lead extraction through the venous system.
No office rate
33241 reports removal of the ICD pulse generator; 33244 reports extraction of ICD leads. A session may involve both distinct services.
Compare 33244 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$750.98
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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 33244 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,872
- Code
- 33244
- Physician work
- 13.40
- Practice expense
- 6.37
- Malpractice
- 3.18
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.40 | × 1.000 | 13.4000 |
| Practice expense | 6.37 | × 1.137 | 7.2427 |
| Malpractice | 3.18 | × 0.579 | 1.8412 |
| Total RVUs | 22.4839 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$750.98
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.4 | 1 |
| Practice expense | 6.37 | 1.137 |
| Malpractice | 3.18 | 0.579 |
(13.4 × 1 + 6.37 × 1.137 + 3.18 × 0.579) × $33.4009 = $750.98
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.
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 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.
3,86933240,,Insrt pulse gen w/singl lead,A,,5.66,2.59,NA,2.59,,1.34,9.59,9.59,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87033241,,Remove pulse generator,A,,2.96,2.26,NA,2.26,,0.70,5.92,5.92,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87133243,,Remove eltrd/thoracotomy,A,,22.98,10.42,NA,10.42,,5.61,39.01,39.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87233244,,Remove elctrd transvenously,A,,13.40,6.37,NA,6.37,,3.18,22.95,22.95,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87333249,,Insj/rplcmt defib w/lead(s),A,,14.55,5.91,NA,5.91,,3.43,23.89,23.89,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8743324F,,Mri ct scan ord rvwd rqstd,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
3,87533250,,Ablate heart dysrhythm focus,A,,25.25,10.37,NA,10.37,,6.05,41.67,41.67,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014