CPT 33263
Global 090 ActiveRmvl & rplcmt dfb gen 2 lead
CPT 33263 Billing & Documentation Guide
CPT code 33263 (Rmvl & rplcmt dfb gen 2 lead) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 5.93, a non-facility practice expense RVU of 2.92, and a malpractice RVU of 1.4, a total non-facility RVU of 10.25 and facility RVU of 10.25. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $343.93, though rates vary from $305.76 to $426.74 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 33263, 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 33263 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 33263 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 33263
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 5.93 | 5.93 |
| Practice Expense RVU | 2.92 | 2.92 |
| Malpractice RVU | 1.4 | 1.4 |
| Total RVU | 10.25 | 10.25 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 33263
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 | $345.93 | $345.93 | $333.39 - $385.56 | 29 |
| Florida | $386.95 | $386.95 | $361.59 - $417.86 | 3 |
| Georgia | $347.36 | $347.36 | $340.8 - $353.91 | 2 |
| Illinois | $382.36 | $382.36 | $360.2 - $404.79 | 4 |
| Michigan | $355.47 | $355.47 | $339.91 - $371.02 | 2 |
| North Carolina | $318.94 | $318.94 | $318.94 - $318.94 | 1 |
| New York | $379.84 | $379.84 | $323.59 - $413.54 | 5 |
| Ohio | $334.25 | $334.25 | $334.25 - $334.25 | 1 |
| Pennsylvania | $345.37 | $345.37 | $331.79 - $358.95 | 2 |
| Texas | $338.61 | $338.61 | $330.26 - $360.84 | 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 33263
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 33263 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 |
| 00534 | 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 | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 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 33263
What does CPT code 33263 mean? +
CPT code 33263 represents: Rmvl & rplcmt dfb gen 2 lead. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 090.
What is the Medicare reimbursement for CPT 33263? +
The 2026 Medicare national average non-facility payment for CPT 33263 is $343.93. Rates range from $305.76 to $426.74 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 33263? +
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 33263? +
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 2, 2026.
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