No office rate
Choose 33280 for generator-only removal with leads retained. Code 33278 is for removal of the stimulator system.
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CMS RVU26D · Effective 2026-10-01
33280 Stimulator removal Medicare reimbursement rates in Pennsylvania
Report removal of an implanted phrenic nerve stimulator pulse generator when the generator is taken out and its lead or leads remain in place. Compare 33280 office and facility rates across CMS payment localities in Pennsylvania.
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 33280 in Pennsylvania?
Pennsylvania 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
$185.04–$201.21
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 33280: Phrenic nerve stimulator generator removal
Report removal of an implanted phrenic nerve stimulator pulse generator when the generator is taken out and its lead or leads remain in place.
This procedure removes the pulse generator from its implanted pocket while leaving the phrenic nerve stimulator lead or leads in place. The device is used to stimulate the phrenic nerve, including for treatment of central sleep apnea. An electrophysiologist or another surgeon experienced with implanted cardiac devices may perform the removal in a surgical setting, such as a hospital or ambulatory surgery center.
Report 33280 when the operative documentation supports generator removal alone; removal of the complete system or removal and replacement of a component calls for a different code. 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 33280
- 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 RVU2.96 · 51%
- Practice expense (office) RVU2.09 · 36%
- Malpractice RVU0.70 · 12%
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.
33280 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Code 33279 addresses removal of the transvenous lead component; 33280 addresses removal of the pulse generator.
No office rate
Use 33287 when the pulse generator is removed and replaced. Code 33280 describes removal without generator replacement.
No office rate
Code 33288 is for removal and replacement of a lead. Code 33280 is for generator removal alone.
Compare 33280 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$201.21
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$185.04
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33280 billing questions
When should 33280 be chosen instead of 33278?
Use 33280 when the pulse generator is removed and the lead or leads stay in place. Code 33278 describes removal of the phrenic nerve stimulator system.
Can 33280 be reported when the generator is replaced?
No. Removal and replacement of the pulse generator is represented by 33287, rather than removal alone.
What documentation supports 33280?
The operative report should identify the pulse generator removal and clarify that the lead or leads were retained. Document the device and the clinical reason for removal.
Can modifier 50 be used for bilateral generator removal?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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 subject to a 50% reduction.
Can an assistant or co-surgeon be billed for this procedure?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing 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.
3,90033277,,Insj phrnc nrv stim transvns,A,,5.29,1.09,NA,1.09,,1.27,7.65,7.65,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90133278,,Rmvl phrnc nrv stim sys,A,,9.31,3.51,NA,3.51,,2.06,14.88,14.88,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90233279,,Rmvl phrnc nrv stim transvns,A,,5.28,2.67,NA,2.67,,1.29,9.24,9.24,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90333280,,Rmvl phrnc nrv stim pg only,A,,2.96,2.09,NA,2.09,,0.70,5.75,5.75,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90433281,,Reposg phrnc nrv stim trnsvn,A,,5.85,2.89,NA,2.89,,1.40,10.14,10.14,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90533285,,Insj subq car rhythm mntr,A,,1.49,118.27,,0.42,,0.36,120.12,2.27,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90633286,,Rmvl subq car rhythm mntr,A,,1.46,2.04,,0.42,,0.36,3.86,2.24,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00