Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); single chamber

CPT 33206 is the billing code for "Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); single chamber". For insertion or replacement of single chamber permanent pacemaker

Medicare pays approximately $435.71 for CPT 33206 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 33206 has a total RVU of 35.25, broken down as: Work RVU 15.50, Practice Expense RVU 18.20, and Malpractice RVU 1.55. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 33206 include: Indication for pacemaker; Pacemaker type and model; Lead placement location; Threshold testing results. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 33206: Includes pacemaker insertion or replacement. Includes lead placement Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 33206 include: 22 (Increased procedural services for complex cases), 51 (Multiple procedures performed same session), 52 (Reduced services if procedure not completed). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 33206 is 60-90 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.