No office rate
33206 describes an atrial single-chamber pacemaker. Choose 33208 when the implanted system has both atrial and ventricular transvenous leads.
On this page
CMS RVU26D · Effective 2026-10-01
33208 Pacemaker implant Medicare reimbursement rates in Wisconsin
Implantation of a permanent dual-chamber pacemaker with transvenous atrial and ventricular leads when pacing support is needed in both chambers. Compare 33208 office and facility rates across CMS payment localities in Wisconsin.
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 33208 in Wisconsin?
Wisconsin 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
$406.10
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
Cardiology procedure
About 33208: Dual-chamber transvenous pacemaker implantation
Implantation of a permanent dual-chamber pacemaker with transvenous atrial and ventricular leads when pacing support is needed in both chambers.
This service covers placement of a permanent dual-chamber transvenous pacemaker: one lead is positioned in the right atrium and another in the right ventricle, then connected to a pulse generator placed in a pocket. Electrophysiologists and cardiologists typically perform the procedure in a hospital electrophysiology laboratory or a comparable procedural setting for patients needing pacing in both chambers.
Report the code once for the dual-chamber system, not separately for each lead. The operative report should support the indication, lead locations, generator placement, and system configuration. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the global period. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant-at-surgery claim for this service. Co-surgeons are permitted; team-surgery billing is not permitted.
CMS billing rules for 33208
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.31 · 61%
- Practice expense (office) RVU3.39 · 25%
- Malpractice RVU1.95 · 14%
89.9K
Medicare services in 2024 · #593 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.
33208 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
33207 describes a ventricular single-chamber pacemaker. Choose 33208 when both atrial and ventricular chambers are included in the implanted system.
No office rate
33213 covers pulse-generator insertion or replacement for a dual-lead system. It is not the complete dual-chamber implant represented by 33208.
No office rate
33214 describes upgrading an existing pacemaker system. Use 33208 for implantation of a new dual-chamber transvenous system.
Compare 33208 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$406.10
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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 33208 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
3,837
- Code
- 33208
- Physician work
- 8.31
- Practice expense
- 3.39
- Malpractice
- 1.95
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.31 | × 1.000 | 8.3100 |
| Practice expense | 3.39 | × 0.958 | 3.2476 |
| Malpractice | 1.95 | × 0.308 | 0.6006 |
| Total RVUs | 12.1582 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$406.10
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.31 | 1 |
| Practice expense | 3.39 | 0.958 |
| Malpractice | 1.95 | 0.308 |
(8.31 × 1 + 3.39 × 0.958 + 1.95 × 0.308) × $33.4009 = $406.10
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.
33208 billing questions
How does 33208 differ from 33206 or 33207?
Use 33208 for a dual-chamber system with both atrial and ventricular transvenous leads. Codes 33206 and 33207 describe single-chamber systems.
Should the leads and generator be billed separately?
For a complete dual-chamber implant, report 33208 once rather than billing separate lines for its atrial lead, ventricular lead, and generator.
When is 33213 used instead?
33213 is for insertion or replacement of a pulse generator in a dual-lead system without the complete lead-and-generator implantation represented by 33208.
How many units should be reported?
Report one unit for the dual-chamber system, not one unit for each transvenous lead.
How are assistant and co-surgeon claims handled?
Medicare does not pay an assistant-at-surgery claim for 33208. Co-surgeons are permitted when the operative circumstances support their separate roles; team-surgery billing is 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.
3,83433203,,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
3,83733208,,Insrt heart pm atrial & vent,A,,8.31,3.39,NA,3.39,,1.95,13.65,13.65,0,090,0.09,0.84,0.07,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8383320F,,No xray/ct/ et al ordd,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
3,83933210,,Insert electrd/pm cath sngl,A,,2.97,0.59,NA,0.59,,0.65,4.21,4.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,84033211,,Insert card electrodes dual,A,,3.06,0.63,NA,0.63,,0.67,4.36,4.36,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,