No office rate
Use 33212 for an existing single-lead system and 33213 for an existing dual-lead system. The lead configuration, not the generator itself, distinguishes these codes.
On this page
CMS RVU26D · Effective 2026-10-01
33212 Pacemaker generator Medicare reimbursement rates in Tennessee
Reports insertion of a pacemaker pulse generator connected to an existing single-lead system, rather than placement of a new lead or generator replacement. Compare 33212 office and facility rates across CMS payment localities in Tennessee.
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 33212 in Tennessee?
Tennessee 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
$266.08
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 surgery
About 33212: Pacemaker generator insertion, single lead system
Reports insertion of a pacemaker pulse generator connected to an existing single-lead system, rather than placement of a new lead or generator replacement.
Code 33212 describes placing a pacemaker pulse generator for a system that already has one transvenous pacing lead. The generator is connected to that retained lead and seated in a surgically created pocket, commonly in the upper chest. Electrophysiologists and other physicians trained in cardiac device implantation perform this work in a hospital or ambulatory surgical setting. The defining distinction is generator-only insertion with one existing lead, rather than implantation of a new lead or replacement of an old generator.
Report 33212 when the operative record supports insertion of the generator and documents the single-lead configuration. Document that the existing lead was retained and connected, and identify the number of leads in the system. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When other procedures subject to the multiple-procedure rule occur in the same session, the highest-valued procedure is paid in full and additional procedures at 50%. 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 33212
- 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 RVU4.88 · 56%
- Practice expense (office) RVU2.71 · 31%
- Malpractice RVU1.16 · 13%
130
Medicare services in 2024 · #4669 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.
33212 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
33221 is for generator insertion with an existing multiple-lead system; 33212 is limited to an existing single-lead system.
No office rate
33227 covers removal and replacement of a generator in a single-lead system. Use 33212 for generator insertion rather than removal and replacement.
No office rate
33207 describes insertion of a new permanent pacemaker system with a ventricular lead. Code 33212 is generator-only insertion with an existing single lead.
Compare 33212 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$266.08
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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 33212 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
3,841
- Code
- 33212
- Physician work
- 4.88
- Practice expense
- 2.71
- Malpractice
- 1.16
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.88 | × 1.000 | 4.8800 |
| Practice expense | 2.71 | × 0.909 | 2.4634 |
| Malpractice | 1.16 | × 0.537 | 0.6229 |
| Total RVUs | 7.9663 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$266.08
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.88 | 1 |
| Practice expense | 2.71 | 0.909 |
| Malpractice | 1.16 | 0.537 |
(4.88 × 1 + 2.71 × 0.909 + 1.16 × 0.537) × $33.4009 = $266.08
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.
33212 billing questions
How does 33212 differ from 33213?
33212 is for generator insertion with an existing single-lead system. Use 33213 when the existing system has dual leads.
When is 33212 used instead of 33227?
33212 describes insertion of a generator for an existing single-lead system. Code 33227 describes removing and replacing a generator in a single-lead system.
What documentation supports 33212?
The operative report should support generator insertion and identify the existing lead configuration, including that the single lead was retained and connected.
What global period applies to 33212?
Medicare assigns a 90-day global period. The day-before preoperative visit and related postoperative care through day 90 are included.
Can an assistant or co-surgeon be billed for 33212?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing are not permitted.
How does the multiple-procedure rule affect 33212?
For procedures subject to the rule performed in the same session, Medicare pays the highest-valued procedure in full and pays additional procedures at 50%.
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.
3,8383320F,,No xray/ct/ et al ordd,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,83933210,,Insert electrd/pm cath sngl,A,,2.97,0.59,NA,0.59,,0.65,4.21,4.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,84033211,,Insert card electrodes dual,A,,3.06,0.63,NA,0.63,,0.67,4.36,4.36,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,84133212,,Insert pulse gen sngl lead,A,,4.88,2.71,NA,2.71,,1.16,8.75,8.75,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,84233213,,Insert pulse gen dual leads,A,,5.15,2.72,NA,2.72,,1.22,9.09,9.09,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,84333214,,Upgrade of pacemaker system,A,,7.40,3.63,NA,3.63,,1.71,12.74,12.74,0,090,0.09,0.84,0.07,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,84433215,,Reposition pacing-defib lead,A,,4.80,2.30,NA,2.30,,1.14,8.24,8.24,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780