Billing code 33280: Stimulator removalMedicare rate & RVUs in Washington
Report removal of an implanted phrenic nerve stimulator pulse generator when the generator is taken out and its lead or leads remain in place.
CMS doesn’t publish an office rate for 33280 in Washington.
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 33280 covers
This procedure removes the pulse generator from its implanted pocket while leaving the phrenic nerve stimulator lead or leads in place. The device is used to stimulate the phrenic nerve, including for treatment of central sleep apnea. An electrophysiologist or another surgeon experienced with implanted cardiac devices may perform the removal in a surgical setting, such as a hospital or ambulatory surgery center.
Report 33280 when the operative documentation supports generator removal alone; removal of the complete system or removal and replacement of a component calls for a different code. 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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.
Where 33280 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $191.45 |
| Seattle (King Cnty) | Unavailable | $208.57 |
How the 33280 rate is calculated
Each of 33280’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 · 33280
RVUs × geographic indexes × conversion factor
Work2.96
2.96 RVUs× 1.000 GPCI
Practice expense2.09
2.09 RVUs× 1.000 GPCI
Malpractice0.70
0.70 RVUs× 1.000 GPCI
Adjusted RVUs
5.7500
Conversion factor
$33.4009
Medicare rate
$192.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33280
33280 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33280
Stimulator 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 · 33280
Stimulator 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
33280 without 51 · national facility
$192.06
Stimulator removal
33280-51 · Second procedure: 50%
$96.03
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%).
33280 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33278Stimulator removal
- Choose 33280 for generator-only removal with leads retained. Code 33278 is for removal of the stimulator system.
- 33279Lead removal
- Code 33279 addresses removal of the transvenous lead component; 33280 addresses removal of the pulse generator.
- 33287Generator exchange
- Use 33287 when the pulse generator is removed and replaced. Code 33280 describes removal without generator replacement.
- 33288Lead exchange
- Code 33288 is for removal and replacement of a lead. Code 33280 is for generator removal alone.
33280 billing questions
When should 33280 be chosen instead of 33278?
Use 33280 when the pulse generator is removed and the lead or leads stay in place. Code 33278 describes removal of the phrenic nerve stimulator system.
Can 33280 be reported when the generator is replaced?
No. Removal and replacement of the pulse generator is represented by 33287, rather than removal alone.
What documentation supports 33280?
The operative report should identify the pulse generator removal and clarify that the lead or leads were retained. Document the device and the clinical reason for removal.
Can modifier 50 be used for bilateral generator removal?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
Can an assistant or co-surgeon be billed for this procedure?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing 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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