No office rate
Use 33226 for repositioning a previously placed transvenous LV lead. Use 33215 for repositioning another type of transvenous pacemaker or defibrillator electrode.
On this page
CMS RVU26D · Effective 2026-10-01
33226 LV lead repositioning Medicare reimbursement rates in Oklahoma
Report 33226 when a previously implanted transvenous left ventricular pacing lead is repositioned to correct its location in a cardiac resynchronization system. Compare 33226 office and facility rates across CMS payment localities in Oklahoma.
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 33226 in Oklahoma?
Oklahoma 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
$400.36
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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 33226: Reposition previously placed left ventricular lead
Report 33226 when a previously implanted transvenous left ventricular pacing lead is repositioned to correct its location in a cardiac resynchronization system.
An electrophysiologist or other cardiac-device implanting specialist repositions a transvenous lead used for left ventricular pacing, commonly in a cardiac resynchronization therapy system. The lead may need adjustment when its position has shifted or is not providing the intended pacing. The work is typically performed in a hospital electrophysiology or cardiac catheterization lab, with imaging used to guide lead manipulation.
Report 33226 for repositioning an existing left ventricular lead, rather than placing a new LV lead or repositioning a different pacing or defibrillator lead. The procedure note should identify the previously placed LV lead, the reason for revision, the repositioning performed, and its final position. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 33226
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU8.46 · 67%
- Practice expense (office) RVU2.20 · 17%
- Malpractice RVU2.01 · 16%
126
Medicare services in 2024 · #4694 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.
33226 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
No office rate
33225 covers placement of an LV pacing lead as an add-on service. 33226 is for repositioning an LV lead that was already placed.
No office rate
33224 describes insertion and connection of an LV pacing lead. Choose 33226 when the service is repositioning an existing LV lead instead of inserting one.
Compare 33226 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
Oklahoma →
Office / nonfacility
Unavailable
Facility
$400.36
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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 33226 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
3,855
- Code
- 33226
- Physician work
- 8.46
- Practice expense
- 2.20
- Malpractice
- 2.01
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.46 | × 1.000 | 8.4600 |
| Practice expense | 2.20 | × 0.893 | 1.9646 |
| Malpractice | 2.01 | × 0.777 | 1.5618 |
| Total RVUs | 11.9864 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Oklahoma$400.36
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.46 | 1 |
| Practice expense | 2.2 | 0.893 |
| Malpractice | 2.01 | 0.777 |
(8.46 × 1 + 2.2 × 0.893 + 2.01 × 0.777) × $33.4009 = $400.36
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.
33226 billing questions
How does 33226 differ from 33215?
33226 is for repositioning a previously placed transvenous left ventricular lead. 33215 applies to repositioning a different transvenous pacemaker or defibrillator electrode.
Should 33226 be used for a newly placed LV lead?
No. It describes repositioning a previously placed LV lead. Code selection for a new lead depends on the insertion service performed.
What documentation supports 33226?
Document that the lead was previously implanted and identify it as the LV pacing lead. Include the reason for repositioning, the work performed, and the lead's final position.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
How is 33226 paid when other procedures occur in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
3,85233223,,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
3,85333224,,Insert pacing lead & connect,A,,8.81,2.33,NA,2.33,,2.08,13.22,13.22,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85433225,,L ventric pacing lead add-on,A,,8.12,1.78,NA,1.78,,1.91,11.81,11.81,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85533226,,Reposition l ventric lead,A,,8.46,2.20,NA,2.20,,2.01,12.67,12.67,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85633227,,Remove&replace pm gen singl,A,,5.12,2.71,NA,2.71,,1.21,9.04,9.04,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85733228,,Remv&replc pm gen dual lead,A,,5.38,2.78,NA,2.78,,1.28,9.44,9.44,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85833229,,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
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193