No office rate
33218 describes repair of one existing pacing-defibrillation lead. Report 33220 when two leads are repaired.
On this page
CMS RVU26D · Effective 2026-10-01
33220 Lead repair Medicare reimbursement rates in Kentucky
Reports operative repair of two existing transvenous pacing or defibrillation leads when both leads are repaired rather than repositioned or replaced. Compare 33220 office and facility rates across CMS payment localities in Kentucky.
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 33220 in Kentucky?
Kentucky 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
$325.97
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 33220: Repair of Two Pacing-Defibrillation Leads
Reports operative repair of two existing transvenous pacing or defibrillation leads when both leads are repaired rather than repositioned or replaced.
33220 represents operative repair of two existing transvenous leads serving a pacemaker or implantable cardioverter-defibrillator system. An electrophysiologist or another physician performing cardiac device surgery typically carries out the work in a hospital or other surgical facility. The defining distinction is repair of two leads, rather than correction of a lead’s position or placement of new electrodes.
Report the code when the operative record supports repair of both existing leads. Document the number of leads and the repair performed so the service can be distinguished from repositioning or insertion. Modifier 50 should not represent the two repaired leads. Medicare assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 33220
- 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 RVU5.75 · 56%
- Practice expense (office) RVU3.11 · 30%
- Malpractice RVU1.36 · 13%
70
Medicare services in 2024 · #5144 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.
33220 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
33215 is for repositioning an existing lead. 33220 is for repairing two existing leads, not changing their position.
No office rate
33217 describes insertion of two new pacing-defibrillation electrodes. 33220 describes repair of two existing leads.
Compare 33220 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$325.97
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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 33220 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
3,849
- Code
- 33220
- Physician work
- 5.75
- Practice expense
- 3.11
- Malpractice
- 1.36
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.75 | × 1.000 | 5.7500 |
| Practice expense | 3.11 | × 0.889 | 2.7648 |
| Malpractice | 1.36 | × 0.915 | 1.2444 |
| Total RVUs | 9.7592 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$325.97
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.75 | 1 |
| Practice expense | 3.11 | 0.889 |
| Malpractice | 1.36 | 0.915 |
(5.75 × 1 + 3.11 × 0.889 + 1.36 × 0.915) × $33.4009 = $325.97
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.
33220 billing questions
How does 33220 differ from 33218?
33220 is for repair of two existing leads; 33218 is for repair of one. Select according to the number of leads repaired.
Should modifier 50 be used for two repaired leads?
No. The two-lead service is represented by 33220 itself; modifier 50 should not be used to represent the lead count.
When is 33215 a better fit?
Use 33215 when the work repositions an existing pacing-defibrillation lead. Use 33220 when two existing leads are repaired.
What documentation supports reporting 33220?
The operative report should identify both existing leads and describe the repair performed on each, distinguishing repair from repositioning or insertion.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
3,84633217,,Insert 2 electrode pm-defib,A,,5.45,3.15,NA,3.15,,1.29,9.89,9.89,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,84733218,,Repair lead pace-defib one,A,,5.67,3.43,NA,3.43,,1.33,10.43,10.43,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8483321F,,Ajcc cncr 0/ia melan docd,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
3,84933220,,Repair lead pace-defib dual,A,,5.75,3.11,NA,3.11,,1.36,10.22,10.22,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85033221,,Insert pulse gen mult leads,A,,5.41,2.84,NA,2.84,,1.29,9.54,9.54,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85133222,,Relocation pocket pacemaker,A,,4.73,3.44,NA,3.44,,1.12,9.29,9.29,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85233223,,Relocate pocket for defib,A,,6.14,3.32,NA,3.32,,1.44,10.90,10.90,0,090,0.09,0.84,0.07,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631