No office rate
Use 33262 for generator exchange in a single-lead ICD system; 33264 is for a multiple-lead system.
On this page
CMS RVU26D · Effective 2026-10-01
33264 ICD generator replacement Medicare reimbursement rates in Illinois
Reports removal and replacement of an implantable defibrillator pulse generator when the existing system has multiple leads, such as a CRT-D system. Compare 33264 office and facility rates across CMS payment localities in Illinois.
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 33264 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$374.15–$420.48
4 of 4 localities have a supported rate.
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.
Where 33264 pays more and less in Illinois
Cardiac device surgery
About 33264: ICD pulse generator replacement, multiple lead system
Reports removal and replacement of an implantable defibrillator pulse generator when the existing system has multiple leads, such as a CRT-D system.
An electrophysiologist or other qualified cardiac proceduralist removes the implanted defibrillator generator and connects a replacement to the existing multiple-lead system. Common indications include battery depletion or generator malfunction. The procedure is typically performed in a hospital electrophysiology lab or operating room; a system with atrial, right-ventricular, and left-ventricular leads is a familiar example. This code describes generator exchange, not implantation of a new lead system.
Select the code based on the existing system’s lead configuration: this multiple-lead code differs from the single- and dual-lead generator replacement codes. Document the device and lead configuration, reason for exchange, generator removal and replacement, and testing performed. The generator exchange includes a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur 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; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 33264
- 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 RVU6.19 · 58%
- Practice expense (office) RVU2.99 · 28%
- Malpractice RVU1.46 · 14%
12.7K
Medicare services in 2024 · #1347 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.
33264 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
Use 33263 for a dual-lead ICD system. Use 33264 when the documented system has multiple leads beyond that configuration.
No office rate
33264 describes exchange of the pulse generator while retaining the existing leads. 33249 is for insertion or replacement of a transvenous ICD system with lead work.
No office rate
33270 concerns a subcutaneous defibrillator system; 33264 is for generator exchange in a multiple-lead ICD system.
Compare 33264 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$420.48
East St. Louis →
Office / nonfacility
Unavailable
Facility
$396.84
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$374.15
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$397.18
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33264 billing questions
How does this code differ from 33263?
33264 is for a multiple-lead ICD system; 33263 is for a dual-lead system. Choose based on the documented configuration of the system whose generator is being replaced.
Can the old generator removal be reported separately?
Removal of the old generator is part of the exchange described by 33264. The code covers replacing the generator while retaining the existing lead system.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code and anatomy.
Is an assistant surgeon payable for this procedure?
CMS identifies a statutory restriction on assistant-at-surgery payment. Co-surgeons and team surgery are also not permitted for this code.
What documentation supports reporting 33264?
Document the ICD system’s multiple-lead configuration, the reason for generator exchange, removal and replacement of the pulse generator, and the work performed to connect and test it.
How does the global period affect follow-up billing?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the standard multiple procedure reduction applies.
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.
3,88433261,,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
3,89033267,,Excl laa open any method,A,,18.04,7.13,NA,7.13,,4.43,29.60,29.60,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00