No office rate
33276 covers implantation of the complete system, including the pulse generator. 33277 covers transvenous lead insertion without the generator.
On this page
CMS RVU26D · Effective 2026-10-01
33276 Phrenic stimulator implant Medicare reimbursement rates in Tennessee
Reports implantation of a complete phrenic nerve stimulation system, including transvenous lead or leads and a pulse generator, for conditions such as central sleep apnea. Compare 33276 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 33276 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
$461.30
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.
Neurostimulation
About 33276: Complete phrenic nerve stimulator implantation
Reports implantation of a complete phrenic nerve stimulation system, including transvenous lead or leads and a pulse generator, for conditions such as central sleep apnea.
This code describes implantation of a complete phrenic nerve stimulation system: transvenous lead or leads and the pulse generator. The system is used to stimulate the phrenic nerve, commonly as treatment for central sleep apnea. An electrophysiologist or another appropriately trained implanting physician typically performs the procedure in a hospital operating room or cardiac catheterization lab.
Report 33276 when the operative record supports placement of the complete system, rather than lead-only insertion or a component removal or replacement. Documentation should identify the indication and the components implanted. The code has a 90-day global period, which includes the related preoperative visit on the preceding day and related postoperative care for 90 days. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 33276
- 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 RVU9.26 · 61%
- Practice expense (office) RVU3.76 · 25%
- Malpractice RVU2.11 · 14%
154
Medicare services in 2024 · #4539 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.
33276 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
33276 is for implanting a complete system; 33278 is for removing a complete phrenic nerve stimulation system.
No office rate
33276 describes initial implantation of the complete system. 33287 describes removing and replacing the pulse generator in an existing system.
No office rate
33276 describes implantation of the complete system. 33288 describes removal and replacement of a phrenic stimulator lead.
Compare 33276 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
$461.30
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 33276 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
3,899
- Code
- 33276
- Physician work
- 9.26
- Practice expense
- 3.76
- Malpractice
- 2.11
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.26 | × 1.000 | 9.2600 |
| Practice expense | 3.76 | × 0.909 | 3.4178 |
| Malpractice | 2.11 | × 0.537 | 1.1331 |
| Total RVUs | 13.8109 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$461.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.26 | 1 |
| Practice expense | 3.76 | 0.909 |
| Malpractice | 2.11 | 0.537 |
(9.26 × 1 + 3.76 × 0.909 + 2.11 × 0.537) × $33.4009 = $461.30
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.
33276 billing questions
When should 33276 be used instead of 33277?
Use 33276 when the complete system, including transvenous lead or leads and the pulse generator, is implanted. Code 33277 is for transvenous lead insertion without the pulse generator.
Are the leads and pulse generator reported separately?
The complete-system insertion is reported with 33276 when both the lead or leads and pulse generator are implanted. The operative documentation should identify the components placed.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Is an assistant surgeon payable for this procedure?
No. CMS lists a statutory restriction on assistant-at-surgery payment for 33276. Co-surgeons and team surgery are also not permitted.
What postoperative care is included in the global period?
The 90-day global period includes the related preoperative visit on the day before surgery and related postoperative care for 90 days.
How are other procedures handled when performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session 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.
3,89633273,,Repos prev impltbl subq dfb,A,,6.34,2.91,NA,2.91,,1.50,10.75,10.75,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89733274,,Tcat insj/rpl perm ldls pm,A,,7.61,3.18,NA,3.18,,1.77,12.56,12.56,0,090,0.09,0.84,0.07,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89833275,,Tcat rmvl perm ldls pm w/img,A,,8.38,3.01,NA,3.01,,2.00,13.39,13.39,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89933276,,Insj phrnc nrv stim sys,A,,9.26,3.76,NA,3.76,,2.11,15.13,15.13,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90033277,,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
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