No office rate
Use 33234 for lead removal from a single-lead pacemaker system. Use 33235 for a dual-lead system.
On this page
CMS RVU26D · Effective 2026-10-01
33235 Pacemaker lead removal Medicare reimbursement rates in Oregon
Reports transvenous removal of electrode leads from a dual-lead pacemaker system, such as for infection, lead malfunction, or access for a new lead. Compare 33235 office and facility rates across CMS payment localities in Oregon.
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 33235 in Oregon?
Oregon 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
$544.52–$572.27
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.
Cardiology procedure
About 33235: Dual-lead pacemaker electrode removal
Reports transvenous removal of electrode leads from a dual-lead pacemaker system, such as for infection, lead malfunction, or access for a new lead.
33235 represents transvenous removal of electrode leads from a permanent pacemaker system configured with two leads. Electrophysiologists and cardiac surgeons commonly perform the procedure in a hospital facility when a lead is infected, damaged, malfunctioning, or must be removed to make room for a new lead. Lead extraction may involve specialized tools when simple traction is not sufficient.
Choose this code for a dual-lead pacemaker system; 33234 describes a single-lead system. Document the implanted system configuration, the lead or leads removed, the transvenous approach, and the clinical reason for removal. Report pacemaker generator removal separately when 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, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate; Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 33235
- 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 RVU9.65 · 57%
- Practice expense (office) RVU5.07 · 30%
- Malpractice RVU2.28 · 13%
4K
Medicare services in 2024 · #2000 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.
33235 compared with similar codes
Office rates for Oregon, from the same CMS release.
No office rate
33236 describes pacemaker electrode removal by thoracotomy. 33235 is for transvenous removal.
No office rate
33233 is for removal of the pacemaker generator, not its electrode leads. Generator removal may be reported separately when both services are performed.
No office rate
33244 is for transvenous removal of defibrillator leads. 33235 applies to leads in a pacemaker system.
Compare 33235 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
Portland →
Office / nonfacility
Unavailable
Facility
$572.27
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$544.52
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33235 billing questions
How does 33235 differ from 33234?
33235 is for lead removal from a dual-lead pacemaker system; 33234 is for a single-lead system. Base the selection on the system configuration.
Can pacemaker generator removal be reported separately?
Yes. When the generator is also removed, report the applicable generator-removal code separately from 33235.
Should modifier 50 be used when both leads are removed?
No. Modifier 50 is inappropriate for this code, even when leads on both sides of the system are removed.
What documentation supports 33235?
Document that the implanted pacemaker is a dual-lead system, which lead or leads were removed, the transvenous approach, and the reason for removal.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code, and co-surgeons 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.
3,86133231,,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
3,86733238,,Remove electrode/thoracotomy,A,,15.02,9.44,NA,9.44,,3.60,28.06,28.06,0,090,0.09,0.84,0.07,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00