No office rate
33233 describes removal of the pacemaker pulse generator. Use 33234 for removal of the electrode from a single-lead system.
On this page
CMS RVU26D · Effective 2026-10-01
33234 Pacemaker lead removal Medicare reimbursement rates in Michigan
Reports transvenous removal of a pacing electrode from a single-lead pacemaker system, such as for lead malfunction or device infection. Compare 33234 office and facility rates across CMS payment localities in Michigan.
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 33234 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$426.27–$465.30
2 of 2 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.
Cardiac device surgery
About 33234: Transvenous Single-Lead Pacemaker Electrode Removal
Reports transvenous removal of a pacing electrode from a single-lead pacemaker system, such as for lead malfunction or device infection.
This service removes a transvenous pacing electrode from a single-lead pacemaker system, whether the lead is atrial or ventricular. It is typically performed by an electrophysiologist or another physician experienced in lead extraction in a hospital setting. Clinical circumstances may include an infected device system or a malfunctioning lead requiring removal. This code describes electrode removal, not removal of the pacemaker pulse generator alone.
Select the code based on the single-lead system and the removal approach. The operative report should identify the system configuration, the electrode removed, the transvenous approach, and the clinical reason for extraction. If the generator is also removed, code 33233 describes that separate service. Medicare assigns a 90-day 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%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 33234
- 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 RVU7.47 · 58%
- Practice expense (office) RVU3.62 · 28%
- Malpractice RVU1.76 · 14%
2.4K
Medicare services in 2024 · #2337 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.
33234 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
33235 applies to a dual-lead pacemaker system; 33234 is for a single-lead system.
No office rate
33244 describes transvenous electrode extraction for an implantable defibrillator system, not a pacemaker system.
Compare 33234 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$465.30
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$426.27
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33234 billing questions
How does 33234 differ from 33235?
33234 is for removal from a single-lead pacemaker system, with an atrial or ventricular lead. Code 33235 is for a dual-lead system.
Does 33234 include removal of the pulse generator?
No. It describes electrode removal; code 33233 describes removal of a pacemaker pulse generator. When both are removed, document each service performed.
Is this code reported for each part of the lead?
Code selection is based on the pacemaker system configuration, not on separate portions of one electrode. Document the single-lead system and the electrode removed.
Can modifier 50 be used for right- and left-sided leads?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor and anatomy do not support modifier 50.
What documentation supports reporting 33234?
The operative report should establish a single-lead pacemaker system, identify the atrial or ventricular electrode removed, describe the transvenous removal, and state the clinical indication.
How does the 90-day global affect follow-up care?
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.
3,86033230,,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
3,86533236,,Remove electrode/thoracotomy,A,,12.41,7.92,NA,7.92,,2.97,23.30,23.30,0,090,0.09,0.84,0.07,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,86633237,,Remove electrode/thoracotomy,A,,13.49,8.15,NA,8.15,,3.22,24.86,24.86,0,090,0.09,0.84,0.07,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00