No office rate
33271 covers insertion of the subcutaneous electrode alone; 33270 covers implantation or replacement of the complete system and includes the electrode.
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CMS RVU26D · Effective 2026-10-01
33270 Defibrillator implant Medicare reimbursement rates in Texas
Reports implantation or replacement of a complete subcutaneous implantable defibrillator system, including its electrode and intraoperative device testing. Compare 33270 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 33270 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 33270 pays more and less in Texas
Cardiac device surgery
About 33270: Subcutaneous defibrillator system implantation
Reports implantation or replacement of a complete subcutaneous implantable defibrillator system, including its electrode and intraoperative device testing.
This service covers placing or replacing a subcutaneous implantable cardioverter-defibrillator system, with the generator under the skin and an electrode positioned beneath the skin along the sternum. The physician also performs the system’s specified intraoperative testing, including arrhythmia induction and evaluation of defibrillation, sensing, or pacing function. Electrophysiologists and cardiac surgeons commonly perform the procedure in a hospital operating room or electrophysiology laboratory for patients who need protection from life-threatening ventricular arrhythmias and are receiving a subcutaneous rather than transvenous system.
Report 33270 for the complete system service, not when the work is limited to inserting an electrode. The operative report should identify whether the system was implanted or replaced, describe the subcutaneous generator and electrode placement, and document the testing performed. CMS assigns a 90-day global period; the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
CMS billing rules for 33270
- 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 RVU8.87 · 60%
- Practice expense (office) RVU3.81 · 26%
- Malpractice RVU2.08 · 14%
757
Medicare services in 2024 · #3202 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.
33270 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
33249 applies to a defibrillator system with transvenous lead(s). Choose 33270 for the complete subcutaneous system.
No office rate
33262 is generator removal and replacement for a single-lead transvenous defibrillator system. It is not the code for replacing a complete subcutaneous system.
No office rate
33272 describes removal of a subcutaneous defibrillator electrode, not implantation or replacement of the complete system.
Compare 33270 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 $493.05 |
| Beaumont | Office Unavailable | Facility $476.61 |
| Brazoria | Office Unavailable | Facility $478.94 |
| Dallas | Office Unavailable | Facility $485.29 |
| Fort Worth | Office Unavailable | Facility $484.92 |
| Galveston | Office Unavailable | Facility $482.53 |
| Houston | Office Unavailable | Facility $520.60 |
| Rest Of Texas | Office Unavailable | Facility $479.77 |
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33270 billing questions
When should 33270 be chosen over 33271?
Use 33270 for implantation or replacement of the complete subcutaneous defibrillator system, including its electrode and specified testing. Code 33271 describes electrode insertion alone.
Can the electrode be reported separately with 33270?
The electrode is part of the complete system service described by 33270. Do not separately report 33271 for the electrode placement included in that service.
How does 33270 differ from 33249?
33270 is for a subcutaneous defibrillator system with an electrode positioned beneath the skin. 33249 is for an implantable defibrillator system using transvenous lead(s).
What postoperative care is included?
CMS assigns 33270 a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for 33270.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50% 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 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.
3,89033267,,Excl laa open any method,A,,18.04,7.13,NA,7.13,,4.43,29.60,29.60,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89133268,,Excl laa opn oth px any meth,A,,2.44,0.48,NA,0.48,,0.59,3.51,3.51,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89233269,,Excl laa thrscp any method,A,,13.95,6.42,NA,6.42,,3.46,23.83,23.83,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89333270,,Ins/rep subq defibrillator,A,,8.87,3.81,NA,3.81,,2.08,14.76,14.76,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89433271,,Insj subq impltbl dfb elctrd,A,,7.31,3.10,NA,3.10,,1.75,12.16,12.16,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89533272,,Rmvl of subq defibrillator,A,,5.28,2.78,NA,2.78,,1.23,9.29,9.29,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89633273,,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