No office rate
33233 is for pacemaker generator removal. Use 33241 for removal of an ICD generator.
On this page
CMS RVU26D · Effective 2026-10-01
33241 ICD generator removal Medicare reimbursement rates in Wyoming
Reports removal of an implanted defibrillator pulse generator when it is removed without same-session replacement and the leads remain in place. Compare 33241 office and facility rates across CMS payment localities in Wyoming.
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 33241 in Wyoming?
Wyoming 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
$191.65
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 device procedure
About 33241: Implantable defibrillator generator removal
Reports removal of an implanted defibrillator pulse generator when it is removed without same-session replacement and the leads remain in place.
Code 33241 covers removal of the pulse generator from an implanted cardioverter-defibrillator (ICD), with the leads left in place. An electrophysiologist or cardiac surgeon typically opens the device pocket, disconnects the generator, and removes it in a hospital operating room or electrophysiology suite. Situations may include a decision to discontinue ICD therapy or a planned removal without immediate replacement.
Use this code for generator removal alone, not for a same-session generator replacement; select the applicable replacement code based on the lead configuration when a new generator is implanted. The operative report should identify the ICD, explain the removal, and document whether leads were retained or separately extracted. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is not appropriate for this single-generator service. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 33241
- 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 RVU2.96 · 50%
- Practice expense (office) RVU2.26 · 38%
- Malpractice RVU0.70 · 12%
4.4K
Medicare services in 2024 · #1960 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.
33241 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
33262 includes ICD generator removal and replacement for a single-lead system; 33241 is removal without same-session replacement.
No office rate
33263 includes ICD generator removal and replacement for a dual-lead system; 33241 reports generator removal alone.
No office rate
33264 includes ICD generator removal and replacement for a multiple-lead system; 33241 reports generator removal alone.
Compare 33241 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$191.65
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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 33241 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,870
- Code
- 33241
- Physician work
- 2.96
- Practice expense
- 2.26
- Malpractice
- 0.70
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.96 | × 1.000 | 2.9600 |
| Practice expense | 2.26 | × 1.000 | 2.2600 |
| Malpractice | 0.70 | × 0.740 | 0.5180 |
| Total RVUs | 5.7380 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$191.65
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.96 | 1 |
| Practice expense | 2.26 | 1 |
| Malpractice | 0.7 | 0.74 |
(2.96 × 1 + 2.26 × 1 + 0.7 × 0.74) × $33.4009 = $191.65
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.
33241 billing questions
How is 33241 different from an ICD generator replacement code?
Use 33241 when the generator is removed without a new generator implanted in the same session. For removal and replacement, use the code that matches the ICD lead configuration.
Can 33241 be reported when an ICD lead is also extracted?
33241 represents the generator removal, not lead extraction. Report the applicable lead-removal service when extraction is performed and documented.
Is modifier 50 appropriate for this service?
No. Modifier 50 is not appropriate for removal of a single ICD generator.
What documentation supports reporting 33241?
The operative report should identify the ICD generator removed, describe its disconnection and removal, and clarify whether the leads remained in place or were separately extracted.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction. The code also carries a 90-day 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.
3,86733238,,Remove electrode/thoracotomy,A,,15.02,9.44,NA,9.44,,3.60,28.06,28.06,0,090,0.09,0.84,0.07,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8683323F,,Clin node stgng docdb/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
3,86933240,,Insrt pulse gen w/singl lead,A,,5.66,2.59,NA,2.59,,1.34,9.59,9.59,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87033241,,Remove pulse generator,A,,2.96,2.26,NA,2.26,,0.70,5.92,5.92,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87133243,,Remove eltrd/thoracotomy,A,,22.98,10.42,NA,10.42,,5.61,39.01,39.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87233244,,Remove elctrd transvenously,A,,13.40,6.37,NA,6.37,,3.18,22.95,22.95,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87333249,,Insj/rplcmt defib w/lead(s),A,,14.55,5.91,NA,5.91,,3.43,23.89,23.89,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,