No office rate
Use 33230 for the defibrillator generator procedure with an existing dual-lead configuration; use 33231 when multiple existing leads are involved.
On this page
CMS RVU26D · Effective 2026-10-01
33231 Defibrillator generator Medicare reimbursement rates in Indiana
Reports placement of an implantable defibrillator pulse generator connected to multiple existing leads, without placement of a new lead system. Compare 33231 office and facility rates across CMS payment localities in Indiana.
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 33231 in Indiana?
Indiana 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
$322.84
1 of 1 localities have a supported rate.
Payment area: Indiana
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 procedure
About 33231: Implantable defibrillator generator, multiple leads
Reports placement of an implantable defibrillator pulse generator connected to multiple existing leads, without placement of a new lead system.
An electrophysiologist or other qualified cardiac surgeon places the defibrillator pulse generator and connects it to multiple leads already implanted in the heart. The procedure commonly takes place in a hospital electrophysiology lab or operating room. The work involves accessing the generator pocket, connecting the existing leads to the new generator, and assessing device function. This code represents generator work rather than placement of a new transvenous lead system.
Select this code when the operative report supports a defibrillator generator procedure with multiple existing leads; document the device type, lead configuration, and work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Medicare does not pay an assistant at surgery for this service; co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 33231
- 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 RVU6.18 · 58%
- Practice expense (office) RVU3.00 · 28%
- Malpractice RVU1.45 · 14%
85
Medicare services in 2024 · #4998 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.
33231 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
33240 is the single-lead defibrillator generator option. This code represents the multiple-lead configuration.
No office rate
33264 describes removal and replacement of a defibrillator generator with multiple leads. This code is for generator placement with multiple existing leads without that replacement service.
No office rate
33249 is for an insertion or replacement procedure involving the transvenous defibrillator system and lead work, rather than generator placement connected to existing leads.
Compare 33231 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
Indiana →
Office / nonfacility
Unavailable
Facility
$322.84
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 33231 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
3,861
- Code
- 33231
- Physician work
- 6.18
- Practice expense
- 3.00
- Malpractice
- 1.45
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.18 | × 1.000 | 6.1800 |
| Practice expense | 3.00 | × 0.927 | 2.7810 |
| Malpractice | 1.45 | × 0.486 | 0.7047 |
| Total RVUs | 9.6657 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$322.84
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.18 | 1 |
| Practice expense | 3 | 0.927 |
| Malpractice | 1.45 | 0.486 |
(6.18 × 1 + 3 × 0.927 + 1.45 × 0.486) × $33.4009 = $322.84
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.
33231 billing questions
How is this code distinguished from the single- or dual-lead generator codes?
Choose based on the existing lead configuration documented for the defibrillator generator procedure. The single-lead and dual-lead options describe different configurations; this code is for multiple existing leads.
Can this code be used when a new defibrillator lead is placed?
This code describes generator placement with multiple existing leads, not placement of a new lead system. When new transvenous leads are part of the procedure, evaluate the complete system code that matches the work performed.
How does this differ from generator removal and replacement?
This code reports placement of a defibrillator generator with multiple existing leads. Code 33264 describes removal and replacement of a defibrillator generator with multiple leads.
What documentation supports the multiple-lead selection?
The operative report should identify the defibrillator generator procedure and describe the existing lead configuration and connections. The documentation should make clear that multiple leads were connected to the generator.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, Medicare pays the highest-valued procedure in full and pays other procedures at 50% when performed in the same session.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery reporting 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.
3,85833229,,Remv&replc pm gen mult leads,A,,5.65,2.89,NA,2.89,,1.33,9.87,9.87,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8593322F,,Melanomaajcc stage 0 or ia,M,,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
3,86033230,,Insrt pulse gen w/dual leads,A,,5.92,2.64,NA,2.64,,1.41,9.97,9.97,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86133231,,Insrt pulse gen w/mult leads,A,,6.18,3.00,NA,3.00,,1.45,10.63,10.63,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86233233,,Removal of pm generator,A,,3.06,2.58,NA,2.58,,0.72,6.36,6.36,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86333234,,Removal of pacemaker system,A,,7.47,3.62,NA,3.62,,1.76,12.85,12.85,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86433235,,Removal pacemaker electrode,A,,9.65,5.07,NA,5.07,,2.28,17.00,17.00,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915