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CMS RVU26D · Effective 2026-10-01

33229 Pacemaker replacement Medicare reimbursement rates in Idaho

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 Idaho.

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 Idaho?

Idaho 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

$298.53

1 of 1 localities have a supported rate.

Payment area: Idaho

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.

Find 33229 in your payment locality →

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 Idaho, from the same CMS release.

33227

Pacemaker generator exchange

Single-lead system

No office rate

Use 33227 for generator replacement in a single-lead pacemaker system; this code is for a multiple-lead system.

33228

Pacemaker generator exchange

Dual-lead system

No office rate

Use 33228 for a dual-lead system. This code applies when the pacemaker system has multiple leads.

33231

Defibrillator generator

Multiple existing leads

No office rate

33231 describes generator insertion with a multiple-lead system. This code describes removing an existing generator and replacing it.

33264

ICD generator replacement

Multiple lead system

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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0
  • Idaho →

    Office / nonfacility

    Unavailable

    Facility

    $298.53

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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 33229 in Idaho.

PPRRVU2026_Oct_nonQPP.csv

3,858

Code
33229
Physician work
5.65
Practice expense
2.89
Malpractice
1.33

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Facility calculation for 33229 in Idaho
ComponentRVULocality factorAdjusted
Physician work5.65× 1.0005.6500
Practice expense2.89× 0.9202.6588
Malpractice1.33× 0.4730.6291
Total RVUs8.9379
Conversion factor× 33.4009

Facility rate, Idaho$298.53

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work5.651
Practice expense2.890.92
Malpractice1.330.473

(5.65 × 1 + 2.89 × 0.92 + 1.33 × 0.473) × $33.4009 = $298.53

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.

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.

RVUs for 33229PPRRVU2026_Oct_nonQPP.csv, line 3,858 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)