CPT 33224
Global 000 ActiveInsert pacing lead & connect
CPT 33224 Billing & Documentation Guide
CPT code 33224 (Insert pacing lead & connect) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 8.81, a non-facility practice expense RVU of 2.33, and a malpractice RVU of 2.08, a total non-facility RVU of 13.22 and facility RVU of 13.22. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $440.96, though rates vary from $390.22 to $562.56 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 33224, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 33224 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 33224 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 33224
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 8.81 | 8.81 |
| Practice Expense RVU | 2.33 | 2.33 |
| Malpractice RVU | 2.08 | 2.08 |
| Total RVU | 13.22 | 13.22 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 33224
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $434.57 | $434.57 | $421.8 - $476.09 | 29 |
| Florida | $507.59 | $507.59 | $473.08 - $550.98 | 3 |
| Georgia | $452.07 | $452.07 | $446.49 - $457.65 | 2 |
| Illinois | $503.25 | $503.25 | $473.9 - $533.98 | 4 |
| Michigan | $465.13 | $465.13 | $443.75 - $486.5 | 2 |
| North Carolina | $411.27 | $411.27 | $411.27 - $411.27 | 1 |
| New York | $489.48 | $489.48 | $417.03 - $534.64 | 5 |
| Ohio | $435.34 | $435.34 | $435.34 - $435.34 | 1 |
| Pennsylvania | $447.41 | $447.41 | $431.36 - $463.46 | 2 |
| Texas | $437.03 | $437.03 | $427.93 - $469.49 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 33224
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 33224 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00530 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00540 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0293T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0294T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0302T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0303T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 33224
What does CPT code 33224 mean? +
CPT code 33224 represents: Insert pacing lead & connect. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 33224? +
The 2026 Medicare national average non-facility payment for CPT 33224 is $440.96. Rates range from $390.22 to $562.56 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 33224? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 33224? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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