Billing code 33249: Defibrillator implantMedicare rate & RVUs in New Jersey
Reports implantation or replacement of a complete transvenous implantable defibrillator system when the procedure includes placement of one or more leads.
CMS doesn’t publish an office rate for 33249 in New Jersey.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 33249 covers
An electrophysiologist or cardiac surgeon places an implantable cardioverter-defibrillator (ICD) generator and transvenous lead or leads, commonly in a hospital electrophysiology lab. The leads pass through a vein into the heart, where the system can detect and treat dangerous ventricular rhythms with electrical therapy. Typical indications include prevention of sudden cardiac death in patients at risk of life-threatening ventricular arrhythmias, or treatment after a qualifying arrhythmic event.
Choose this code when the procedure involves the complete transvenous ICD system, including lead placement, rather than a generator-only service. The operative report should identify the indication, implanted generator, lead placement, and whether the procedure was an insertion or replacement. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery services are not paid; co-surgeons require supporting documentation, and team surgery is not permitted.
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.
Where 33249 pays more and less in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern Nj | Unavailable | $867.94 |
| Rest Of New Jersey | Unavailable | $846.66 |
How the 33249 rate is calculated
Each of 33249’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 33249
RVUs × geographic indexes × conversion factor
Work14.55
14.55 RVUs× 1.000 GPCI
Practice expense5.91
5.91 RVUs× 1.000 GPCI
Malpractice3.43
3.43 RVUs× 1.000 GPCI
Adjusted RVUs
23.8900
Conversion factor
$33.4009
Medicare rate
$797.95
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33249
33249 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33249
Defibrillator implant
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33249
Defibrillator implant
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33249 without 51 · national facility
$797.95
Defibrillator implant
33249-51 · Second procedure: 50%
$398.98
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
33249 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33240Defibrillator generator
- 33249 includes transvenous lead placement as part of the ICD system procedure. Use 33240 for the applicable generator-only service without lead placement.
- 33263ICD generator exchange
- 33263 reports removal and replacement of a generator in a dual-lead ICD system when the leads are retained; 33249 includes transvenous lead placement.
- 33264ICD generator replacement
- 33264 reports removal and replacement of a generator in a multiple-lead ICD system when the leads are retained; 33249 includes transvenous lead placement.
33249 billing questions
When should this code be used instead of a generator-only code?
Use 33249 when the procedure includes placement of transvenous lead(s) as part of the ICD system. A generator-only procedure without lead placement is represented by a different code.
Does this code cover a single- or dual-chamber system?
It covers a transvenous ICD system with one or more leads, including single- or dual-chamber configurations. Document the leads placed and the implanted system.
What documentation supports reporting 33249?
The operative report should establish the ICD indication and describe the generator and transvenous lead placement, including whether the system was newly implanted or replaced.
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.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery services are not paid; co-surgeons require supporting documentation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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