No office rate
33249 includes transvenous lead placement as part of the ICD system procedure. Use 33240 for the applicable generator-only service without lead placement.
On this page
CMS RVU26D · Effective 2026-10-01
33249 Defibrillator implant Medicare reimbursement rates in Idaho
Reports implantation or replacement of a complete transvenous implantable defibrillator system when the procedure includes placement of one or more leads. Compare 33249 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 33249 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
$721.78
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.
Cardiac device surgery
About 33249: Transvenous implantable defibrillator system placement
Reports implantation or replacement of a complete transvenous implantable defibrillator system when the procedure includes placement of one or more leads.
An electrophysiologist or cardiac surgeon places an implantable cardioverter-defibrillator (ICD) generator and transvenous lead or leads, commonly in a hospital electrophysiology lab. The leads pass through a vein into the heart, where the system can detect and treat dangerous ventricular rhythms with electrical therapy. Typical indications include prevention of sudden cardiac death in patients at risk of life-threatening ventricular arrhythmias, or treatment after a qualifying arrhythmic event.
Choose this code when the procedure involves the complete transvenous ICD system, including lead placement, rather than a generator-only service. The operative report should identify the indication, implanted generator, lead placement, and whether the procedure was an insertion or replacement. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery services are not paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 33249
- 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 RVU14.55 · 61%
- Practice expense (office) RVU5.91 · 25%
- Malpractice RVU3.43 · 14%
28.8K
Medicare services in 2024 · #987 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.
33249 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
33263 reports removal and replacement of a generator in a dual-lead ICD system when the leads are retained; 33249 includes transvenous lead placement.
No office rate
33264 reports removal and replacement of a generator in a multiple-lead ICD system when the leads are retained; 33249 includes transvenous lead placement.
Compare 33249 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
Idaho →
Office / nonfacility
Unavailable
Facility
$721.78
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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 33249 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
3,873
- Code
- 33249
- Physician work
- 14.55
- Practice expense
- 5.91
- Malpractice
- 3.43
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.55 | × 1.000 | 14.5500 |
| Practice expense | 5.91 | × 0.920 | 5.4372 |
| Malpractice | 3.43 | × 0.473 | 1.6224 |
| Total RVUs | 21.6096 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$721.78
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.55 | 1 |
| Practice expense | 5.91 | 0.92 |
| Malpractice | 3.43 | 0.473 |
(14.55 × 1 + 5.91 × 0.92 + 3.43 × 0.473) × $33.4009 = $721.78
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.
33249 billing questions
When should this code be used instead of a generator-only code?
Use 33249 when the procedure includes placement of transvenous lead(s) as part of the ICD system. A generator-only procedure without lead placement is represented by a different code.
Does this code cover a single- or dual-chamber system?
It covers a transvenous ICD system with one or more leads, including single- or dual-chamber configurations. Document the leads placed and the implanted system.
What documentation supports reporting 33249?
The operative report should establish the ICD indication and describe the generator and transvenous lead placement, including whether the system was newly implanted or replaced.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery services are not paid; co-surgeons require supporting documentation.
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.
3,87033241,,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
3,87633251,,Ablate heart dysrhythm focus,A,,28.20,10.60,NA,10.60,,7.10,45.90,45.90,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772