No office rate
Choose 33288 when a removed lead is replaced during the service. Choose 33279 for lead removal without replacement.
On this page
CMS RVU26D · Effective 2026-10-01
33288 Lead exchange Medicare reimbursement rates in Vermont
Reports removal and replacement of an implanted phrenic nerve stimulator lead, typically when an existing lead needs exchange during device treatment for central sleep apnea. Compare 33288 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 33288 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
$424.72
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 33288: Phrenic nerve stimulator lead exchange
Reports removal and replacement of an implanted phrenic nerve stimulator lead, typically when an existing lead needs exchange during device treatment for central sleep apnea.
This operation removes an existing lead of an implanted phrenic nerve stimulation system and places a replacement lead. An electrophysiologist or other implanting physician typically performs it in a hospital procedural suite when a transvenous lead used for central sleep apnea treatment needs exchange, such as because of damage or loss of function. It is distinct from repositioning a usable lead or replacing only the pulse generator.
Report 33288 for removal and replacement of the lead during the same operative service. Documentation should identify the existing lead, the reason for exchange, removal and replacement work, and device testing. The 90-day global 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 are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 33288
- 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 RVU8.30 · 61%
- Practice expense (office) RVU3.52 · 26%
- Malpractice RVU1.84 · 13%
19
Medicare services in 2024 · #5945 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.
33288 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
33281 is for repositioning a usable transvenous lead. 33288 involves removing the existing lead and placing a replacement.
No office rate
33287 describes pulse-generator removal and replacement; 33288 describes lead removal and replacement.
No office rate
33277 describes lead placement in a phrenic nerve stimulation system. 33288 is for exchanging an existing lead.
Compare 33288 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
$424.72
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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 33288 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,908
- Code
- 33288
- Physician work
- 8.30
- Practice expense
- 3.52
- Malpractice
- 1.84
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.30 | × 1.000 | 8.3000 |
| Practice expense | 3.52 | × 0.990 | 3.4848 |
| Malpractice | 1.84 | × 0.506 | 0.9310 |
| Total RVUs | 12.7158 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$424.72
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.3 | 1 |
| Practice expense | 3.52 | 0.99 |
| Malpractice | 1.84 | 0.506 |
(8.3 × 1 + 3.52 × 0.99 + 1.84 × 0.506) × $33.4009 = $424.72
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.
33288 billing questions
When is 33288 reported instead of 33279?
Use 33288 when the existing lead is removed and a replacement lead is placed. Code 33279 describes lead removal without replacement.
Does repositioning a lead qualify for 33288?
No. Repositioning a usable transvenous lead is distinct from removing and replacing it; 33281 describes lead repositioning.
How is pulse-generator replacement distinguished from lead exchange?
33288 is for lead removal and replacement. Code 33287 describes removal and replacement of the pulse generator, while 33280 describes pulse-generator removal only.
What documentation supports reporting 33288?
Document the existing lead, why it required exchange, the removal and placement of the replacement lead, and device testing.
How does the global period affect postoperative billing?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be billed for this operation?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery 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 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.
3,90533285,,Insj subq car rhythm mntr,A,,1.49,118.27,,0.42,,0.36,120.12,2.27,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90633286,,Rmvl subq car rhythm mntr,A,,1.46,2.04,,0.42,,0.36,3.86,2.24,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90733287,,Rmv&rplcmt phrnc nrv stim pg,A,,5.90,2.97,NA,2.97,,1.34,10.21,10.21,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90833288,,Rmv&rplcmt phrnc nrv stim ld,A,,8.30,3.52,NA,3.52,,1.84,13.66,13.66,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,90933289,,Tcat impl wrls p-art prs snr,A,,5.85,1.47,NA,1.47,,1.19,8.51,8.51,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,9103328F,,Prfrmnc docd 2 wks b/4 surg,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
3,91133300,,Repair of heart wound,A,,43.85,13.23,NA,13.23,,10.85,67.93,67.93,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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