No office rate
33225 is an add-on for left ventricular lead placement with a qualifying primary procedure. Code 33224 describes a distinct left ventricular lead service; choose based on the procedure performed.
On this page
CMS RVU26D · Effective 2026-10-01
33225 LV pacing lead Medicare reimbursement rates in Texas
Reports placement of a left ventricular pacing lead in the cardiac venous system as an add-on during a qualifying pacemaker or defibrillator procedure. Compare 33225 office and facility rates across CMS payment localities in Texas.
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 33225 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No 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.
Where 33225 pays more and less in Texas
Cardiac device procedure
About 33225: Left ventricular pacing lead add-on
Reports placement of a left ventricular pacing lead in the cardiac venous system as an add-on during a qualifying pacemaker or defibrillator procedure.
An electrophysiologist or other physician who implants cardiac devices places a lead through the cardiac venous system to pace the left ventricle, commonly as part of a cardiac resynchronization therapy system. The lead is generally positioned through the coronary sinus and connected as part of a pacemaker or implantable defibrillator procedure in an electrophysiology or cardiac catheterization lab.
Report 33225 only with an eligible primary procedure; it is not a stand-alone service. The operative report should support placement of the left ventricular pacing lead and identify the related generator procedure. CMS treats this as an add-on code, paid within the primary procedure's global period. The primary procedure establishes the applicable global period, so the lead service is not reported as a separate primary procedure.
CMS billing rules for 33225
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU8.12 · 69%
- Practice expense (office) RVU1.78 · 15%
- Malpractice RVU1.91 · 16%
23.5K
Medicare services in 2024 · #1076 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.
33225 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
Use 33225 for placement of a left ventricular lead with a primary procedure. Use 33226 when the work repositions an existing left ventricular lead.
No office rate
33221 reports insertion of a multiple-lead pacemaker generator. It may be the primary procedure; 33225 separately identifies qualifying left ventricular lead placement as an add-on.
Compare 33225 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $391.18 |
| Beaumont | Office Unavailable | Facility $384.58 |
| Brazoria | Office Unavailable | Facility $382.06 |
| Dallas | Office Unavailable | Facility $387.61 |
| Fort Worth | Office Unavailable | Facility $387.84 |
| Galveston | Office Unavailable | Facility $385.25 |
| Houston | Office Unavailable | Facility $420.21 |
| Rest Of Texas | Office Unavailable | Facility $385.24 |
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33225 billing questions
Can 33225 be reported by itself?
No. It is an add-on for left ventricular lead placement performed with an eligible primary pacemaker or defibrillator procedure.
What distinguishes 33225 from 33226?
33225 reports placement of a left ventricular pacing lead with a qualifying primary procedure. Code 33226 is for repositioning an existing left ventricular lead.
What documentation supports 33225?
The operative report should describe placement of the left ventricular lead in the cardiac venous system and identify the primary generator procedure performed.
Is 33225 reported with a pacemaker or a defibrillator procedure?
It may accompany an eligible primary procedure for either type of device. The documentation must support the lead placement and the related primary procedure.
How does 33225 differ from 33224?
Both concern left ventricular pacing leads, but 33225 is specifically an add-on reported with a primary procedure. Select 33224 for the distinct lead service it describes, based on the procedure performed.
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.
3,85133222,,Relocation pocket pacemaker,A,,4.73,3.44,NA,3.44,,1.12,9.29,9.29,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85233223,,Relocate pocket for defib,A,,6.14,3.32,NA,3.32,,1.44,10.90,10.90,0,090,0.09,0.84,0.07,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85333224,,Insert pacing lead & connect,A,,8.81,2.33,NA,2.33,,2.08,13.22,13.22,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85433225,,L ventric pacing lead add-on,A,,8.12,1.78,NA,1.78,,1.91,11.81,11.81,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85533226,,Reposition l ventric lead,A,,8.46,2.20,NA,2.20,,2.01,12.67,12.67,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85633227,,Remove&replace pm gen singl,A,,5.12,2.71,NA,2.71,,1.21,9.04,9.04,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,85733228,,Remv&replc pm gen dual lead,A,,5.38,2.78,NA,2.78,,1.28,9.44,9.44,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00