No office rate
Both involve epicardial electrode placement, but 33202 is the open approach and 33203 is the endoscopic approach.
On this page
CMS RVU26D · Effective 2026-10-01
33202 Epicardial lead Medicare reimbursement rates in Vermont
Reports open surgical placement of epicardial pacing electrode(s), commonly when transvenous lead placement is unsuitable or impractical. Compare 33202 office and facility rates across CMS payment localities in Vermont.
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 33202 in Vermont?
Vermont 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
$686.81
1 of 1 localities have a supported rate.
Payment area: Vermont
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 33202: Open epicardial pacing electrode insertion
Reports open surgical placement of epicardial pacing electrode(s), commonly when transvenous lead placement is unsuitable or impractical.
The surgeon places pacing electrode(s) directly on the heart’s outer surface through an open chest approach. This is used when a transvenous route is unsuitable or impractical, including in some patients with congenital heart disease, limited venous access, or small body size. A cardiothoracic surgeon typically performs the procedure in an operating room. This code represents electrode placement, not placement of the pulse generator.
Report it for open epicardial electrode placement, rather than endoscopic placement or transvenous lead insertion. The operative report should support the open approach and document the electrode placement. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 33202
- 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 RVU12.87 · 58%
- Practice expense (office) RVU6.15 · 28%
- Malpractice RVU3.17 · 14%
433
Medicare services in 2024 · #3669 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.
33202 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
33206 describes atrial pacemaker implantation with transvenous electrode(s); 33202 is for open placement of epicardial electrode(s).
No office rate
33208 describes dual-chamber pacemaker implantation using transvenous electrode(s). Choose 33202 for open epicardial electrode placement, not transvenous implantation.
No office rate
33212 represents pulse-generator placement for a single-lead system, while 33202 represents open epicardial electrode placement.
Compare 33202 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
Vermont →
Office / nonfacility
Unavailable
Facility
$686.81
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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 33202 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,833
- Code
- 33202
- Physician work
- 12.87
- Practice expense
- 6.15
- Malpractice
- 3.17
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.87 | × 1.000 | 12.8700 |
| Practice expense | 6.15 | × 0.990 | 6.0885 |
| Malpractice | 3.17 | × 0.506 | 1.6040 |
| Total RVUs | 20.5625 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$686.81
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.87 | 1 |
| Practice expense | 6.15 | 0.99 |
| Malpractice | 3.17 | 0.506 |
(12.87 × 1 + 6.15 × 0.99 + 3.17 × 0.506) × $33.4009 = $686.81
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.
33202 billing questions
How does 33202 differ from 33203?
33202 is for open placement of epicardial electrode(s). Use 33203 when the electrode placement is performed endoscopically.
Is the pacemaker generator included?
No. This code captures open epicardial electrode placement, not pulse-generator placement. When a generator is also implanted, determine the appropriate generator code from the system and procedure performed.
How does this differ from transvenous pacemaker implantation?
33202 describes epicardial electrode placement through an open approach. Codes such as 33206–33208 describe pacemaker insertion using transvenous electrodes.
What documentation supports reporting 33202?
The operative report should establish that the surgeon used an open approach and placed epicardial pacing electrode(s) on the heart’s outer surface.
Can modifier 50 be used for electrodes placed on both sides?
No. CMS identifies bilateral adjustment as inapplicable for this code; modifier 50 is inappropriate.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
3,8303317F,,Path rpt malig cancer docd,I,,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
3,8313318F,,Path rpt malig cancer docd,I,,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
3,8323319F,,X-ray/ct/ultrsnd et al ord,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
3,83333202,,Insert epicard eltrd open,A,,12.87,6.15,NA,6.15,,3.17,22.19,22.19,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,83433203,,Insert epicard eltrd endo,A,,13.62,6.04,NA,6.04,,3.43,23.09,23.09,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,83533206,,Insert heart pm atrial,A,,6.96,3.45,NA,3.45,,1.63,12.04,12.04,0,090,0.09,0.84,0.07,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,83633207,,Insert heart pm ventricular,A,,7.61,3.25,NA,3.25,,1.78,12.64,12.64,0,090,0.09,0.84,0.07,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817