No office rate
Use 33262 for generator exchange in a single-lead ICD system. This code is for a dual-lead system.
On this page
CMS RVU26D · Effective 2026-10-01
33263 ICD generator exchange Medicare reimbursement rates in Idaho
Removal and replacement of an implantable cardioverter-defibrillator generator connected to an existing dual-lead system, commonly performed when the generator reaches replacement status. Compare 33263 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 33263 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
$309.91
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 procedures
About 33263: Dual-lead ICD generator replacement
Removal and replacement of an implantable cardioverter-defibrillator generator connected to an existing dual-lead system, commonly performed when the generator reaches replacement status.
This service replaces the pulse generator of an implanted cardioverter-defibrillator while retaining the existing dual-lead system. It is commonly performed when the generator reaches replacement status. Cardiologists and cardiac electrophysiologists typically perform the exchange in a hospital electrophysiology lab or other surgical facility. The dual-lead configuration distinguishes this service from generator exchanges for single-lead or multiple-lead systems.
Report the service when the operative documentation supports removal and replacement of the generator and identifies the dual-lead configuration. The record should describe the generator exchange and the disposition of the existing leads. CMS assigns a 90-day global period, including 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 33263
- 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 RVU5.93 · 58%
- Practice expense (office) RVU2.92 · 28%
- Malpractice RVU1.40 · 14%
6.1K
Medicare services in 2024 · #1740 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.
33263 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
Use 33264 for generator exchange in a multiple-lead ICD system. This code identifies the dual-lead configuration.
No office rate
33249 describes insertion or replacement of an ICD system with transvenous leads. This code describes exchange of the generator in an existing dual-lead system.
Compare 33263 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
$309.91
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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 33263 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
3,886
- Code
- 33263
- Physician work
- 5.93
- Practice expense
- 2.92
- Malpractice
- 1.40
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.93 | × 1.000 | 5.9300 |
| Practice expense | 2.92 | × 0.920 | 2.6864 |
| Malpractice | 1.40 | × 0.473 | 0.6622 |
| Total RVUs | 9.2786 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$309.91
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.93 | 1 |
| Practice expense | 2.92 | 0.92 |
| Malpractice | 1.4 | 0.473 |
(5.93 × 1 + 2.92 × 0.92 + 1.4 × 0.473) × $33.4009 = $309.91
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.
33263 billing questions
How is this code distinguished from 33262 and 33264?
This code is for a dual-lead ICD system. Code 33262 describes a single-lead system, while 33264 describes a multiple-lead system.
Does this code describe replacing the leads as well as the generator?
It describes exchange of the ICD generator for an existing dual-lead system. If lead placement or revision is performed, document that work and determine the appropriate coding separately.
What documentation supports the dual-lead selection?
Document the generator removal and replacement and identify the existing system as dual-lead, including the status or disposition of those leads.
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.
Can an assistant or co-surgeon be reported?
Medicare does not pay for an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure reduction.
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.
3,8833325F,,Preop asses 4 cataract surg,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
3,88433261,,Ablate heart dysrhythm focus,A,,28.20,10.97,NA,10.97,,6.75,45.92,45.92,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88533262,,Rmvl& replc pulse gen 1 lead,A,,5.66,2.87,NA,2.87,,1.33,9.86,9.86,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88633263,,Rmvl & rplcmt dfb gen 2 lead,A,,5.93,2.92,NA,2.92,,1.40,10.25,10.25,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88733264,,Rmvl & rplcmt dfb gen mlt ld,A,,6.19,2.99,NA,2.99,,1.46,10.64,10.64,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88833265,,Ablate atria lmtd endo,A,,23.12,9.94,NA,9.94,,5.69,38.75,38.75,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88933266,,Ablate atria x10sv endo,A,,32.21,11.93,NA,11.93,,7.98,52.12,52.12,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,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