Billing code 33235: Pacemaker lead removalMedicare rate & RVUs in Utah
Reports transvenous removal of electrode leads from a dual-lead pacemaker system, such as for infection, lead malfunction, or access for a new lead.
CMS doesn’t publish an office rate for 33235 in Utah.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 33235 covers
33235 represents transvenous removal of electrode leads from a permanent pacemaker system configured with two leads. Electrophysiologists and cardiac surgeons commonly perform the procedure in a hospital facility when a lead is infected, damaged, malfunctioning, or must be removed to make room for a new lead. Lead extraction may involve specialized tools when simple traction is not sufficient.
Choose this code for a dual-lead pacemaker system; 33234 describes a single-lead system. Document the implanted system configuration, the lead or leads removed, the transvenous approach, and the clinical reason for removal. Report pacemaker generator removal separately when performed. 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 the others at 50%. Modifier 50 is inappropriate; Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
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.
33235 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $549.89 |
How the 33235 rate is calculated
Each of 33235’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 33235
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.65Practice expense 5.07Malpractice 2.28
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33235
33235 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33235
Pacemaker lead removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33235
Pacemaker lead removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33235 without 51 · national facility
$567.82
Pacemaker lead removal
33235-51 · Second procedure: 50%
$283.91
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
33235 compared with similar codes
Compare codes
33235 vs 33234 vs 33236 vs 33233 vs 33244: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33234Pacemaker lead removal
- Use 33234 for lead removal from a single-lead pacemaker system. Use 33235 for a dual-lead system.
- 33236Lead removal
- 33236 describes pacemaker electrode removal by thoracotomy. 33235 is for transvenous removal.
- 33233Pacemaker generator removal
- 33233 is for removal of the pacemaker generator, not its electrode leads. Generator removal may be reported separately when both services are performed.
- 33244ICD lead extraction
- 33244 is for transvenous removal of defibrillator leads. 33235 applies to leads in a pacemaker system.
33235 billing questions
How does 33235 differ from 33234?
33235 is for lead removal from a dual-lead pacemaker system; 33234 is for a single-lead system. Base the selection on the system configuration.
Can pacemaker generator removal be reported separately?
Yes. When the generator is also removed, report the applicable generator-removal code separately from 33235.
Should modifier 50 be used when both leads are removed?
No. Modifier 50 is inappropriate for this code, even when leads on both sides of the system are removed.
What documentation supports 33235?
Document that the implanted pacemaker is a dual-lead system, which lead or leads were removed, the transvenous approach, and the reason for removal.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code, and co-surgeons 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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