Billing code 33274: Leadless pacemakerMedicare rate & RVUs in Oregon
Report this service when a clinician places or replaces a permanent leadless pacemaker in the right ventricle using a transcatheter approach.
CMS doesn’t publish an office rate for 33274 in Oregon.
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 33274 covers
An electrophysiologist or other qualified cardiac specialist delivers a permanent, self-contained pacing device through a catheter into the right ventricle, typically through venous access in a hospital electrophysiology or catheterization lab. Unlike a conventional pacemaker, the leadless device sits inside the heart and does not use a chest pocket or transvenous pacing lead. The service includes imaging guidance and device evaluation associated with placement or replacement.
Select this code for right-ventricular leadless device insertion or replacement, not for a conventional transvenous pacemaker or a subcutaneous defibrillator. Document the clinical indication, transcatheter placement or replacement, device location, and evaluation. If an existing leadless device is removed during replacement, report the removal service separately when performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeons are permitted, but team surgery is not.
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 33274 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $420.24 |
| Rest Of Oregon | Unavailable | $401.53 |
How the 33274 rate is calculated
Each of 33274’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 · 33274
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.61Practice expense 3.18Malpractice 1.77
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33274
33274 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33274
Leadless pacemaker
| 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) | 2 | Permitted. |
| 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 · 33274
Leadless pacemaker
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
33274 without 51 · national facility
$419.52
Leadless pacemaker
33274-51 · Second procedure: 50%
$209.76
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%).
33274 compared with similar codes
Compare codes
33274 vs 33275 vs 33207 vs 33208 vs 33262: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33275Pacemaker removal
- 33275 describes transcatheter removal of a permanent leadless pacemaker. Use it for extraction; 33274 covers placement or replacement of the right-ventricular leadless device.
- 33207Pacemaker insertion
- 33207 is for a conventional ventricular pacemaker system with a transvenous electrode. Choose 33274 when the pacing device is leadless and placed in the right ventricle by catheter.
- 33208Pacemaker implant
- 33208 describes a conventional dual-chamber pacemaker system using transvenous electrodes. It is not the code for a single leadless device placed in the right ventricle.
- 33262Defibrillator exchange
- 33262 reports generator removal and replacement in a single-lead pacing system. It does not describe transcatheter insertion or replacement of a leadless pacemaker.
33274 billing questions
How is this different from a conventional pacemaker insertion?
This code is for a self-contained leadless device delivered into the right ventricle by catheter. Codes such as 33207 or 33208 describe a conventional system using transvenous electrode leads.
Can the removal of an existing leadless pacemaker be reported separately?
Yes, when removal is performed during replacement, report the removal service separately with 33275. Document the extraction as well as the new device placement.
Is imaging guidance separately reported?
Imaging guidance and the associated device evaluation are included in this service. Do not separately report those included elements as though they were independent services.
Does this code have a postoperative global period?
Yes. It has a 90-day global period that includes the day-before preoperative visit and related postoperative care.
Which surgical modifiers or assistant services should be considered?
Modifier 50 is inappropriate for this code. CMS permits co-surgeons, restricts payment for an assistant at surgery, and does not permit team surgery.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a reduction when performed in the same session.
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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