How much does Medicare pay for CPT 33228?

Medicare allowed an average of $1057.50 per service and paid $835.44 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4467.66, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 33228?

Removal and replacement of dual lead permanent pacemaker. It was billed 14,972 times to 14,964 Medicare beneficiaries by 904 providers in 2024.

Does 33228 pay differently in an office than a hospital?

Yes. The allowed amount averaged $336.42 in an office setting and $1058.76 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 33228 most?

Clinical Cardiac Electrophysiology, with 8,943 services from 555 clinicians. Next are Cardiology, Ambulatory Surgical Center, Interventional Cardiology.

CPT 33228

Removal and replacement of dual lead permanent pacemaker

$1057.50Medicare-allowed amount per service, averaged across 14,972 services

Providers submitted

$4467.66

Asking price, not received

Medicare allowed

$1057.50

The fee schedule figure

Medicare paid

$835.44

Balance is patient coinsurance

Providers submitted an average of $4467.66 for this code and Medicare allowed $1057.50 — 4.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $835.44 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $336.42
Hospital / facility: $1058.76

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 26 services were billed in an office setting and 14,946 in a facility.

Services: 14,972
Beneficiaries: 14,964
Providers billing it: 904
Total allowed: $15,832,890

What Medicare pays for CPT 33228

Across 14,972 services billed by 904 providers to 14,964 beneficiaries, Medicare allowed an average of $1057.50 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 33228

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Cardiac Electrophysiology	8,943	8,938	$342.83	555
Cardiology	3,503	3,502	$335.82	221
Ambulatory Surgical Center	1,550	1,548	$7260.69	65
Interventional Cardiology	469	469	$346.83	30
Internal Medicine	313	313	$342.50	19
Thoracic Surgery	64	64	$354.55	5
Cardiac Surgery	58	58	$353.20	4
Family Practice	22	22	$332.28	1
Vascular Surgery	13	13	$336.00	1
Undefined Physician type	13	13	$318.63	1
Interventional Radiology	12	12	$309.87	1
Critical Care (Intensivists)	12	12	$334.95	1

33228 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	1,640	$1892.73	$1596.71	88
California	1,058	$2109.96	$1420.77	67
Texas	1,032	$1801.91	$1490.47	65
New York	830	$386.28	$260.69	53
Illinois	623	$697.03	$522.49	39
Arizona	610	$2944.33	$2401.83	30
Virginia	553	$1113.38	$908.86	30
Pennsylvania	537	$341.46	$264.78	34
New Jersey	495	$1016.92	$750.48	29
Ohio	467	$331.98	$264.12	31
Massachusetts	422	$355.71	$263.48	29
Maryland	417	$586.88	$439.12	23
Tennessee	417	$314.34	$260.08	25
North Carolina	361	$319.28	$263.76	24
Kansas	350	$1714.47	$1494.50	17
Arkansas	348	$306.20	$266.93	16
Georgia	337	$338.19	$262.83	24
Missouri	295	$1065.87	$862.57	19
Nebraska	290	$605.38	$511.53	17
South Carolina	274	$769.22	$649.63	18
Washington	262	$339.58	$258.50	17
Alabama	259	$310.90	$261.15	13
Indiana	253	$312.92	$264.79	19
Louisiana	245	$2066.80	$1789.69	14
Michigan	238	$648.01	$523.51	16
Kentucky	193	$331.32	$260.37	12
Oklahoma	184	$1146.84	$956.75	11
Mississippi	167	$845.09	$732.60	10
Colorado	152	$338.85	$267.63	9
Oregon	145	$1482.76	$1113.24	10
Minnesota	129	$1442.54	$1118.92	8
South Dakota	125	$316.64	$265.57	6
Wisconsin	121	$308.97	$259.21	10
Nevada	120	$324.08	$262.10	8
New Hampshire	119	$342.74	$256.52	8
West Virginia	110	$341.80	$264.54	7
Idaho	107	$308.62	$257.69	6
Utah	107	$330.26	$252.09	6
Iowa	107	$307.25	$266.31	6
Connecticut	86	$367.09	$260.02	5
Delaware	76	$338.63	$271.51	5
Alaska	71	$3587.35	$2620.88	4
Montana	49	$343.89	$270.84	3
Vermont	44	$322.77	$250.22	3
Hawaii	40	$337.55	$258.17	2
Maine	36	$332.68	$264.77	3
North Dakota	32	$321.31	$252.42	2
Wyoming	15	$353.26	$272.65	1
New Mexico	12	$328.64	$269.86	1
District of Columbia	12	$383.00	$266.44	1

Related codes

33208Insertion of pacemaker and upper and lower heart chamber electrode$734.65
33285Insertion of heart rhythm monitor under skin$1927.21
33249Insertion of implantable defibrillator system$1981.50
33225Insertion of left lower heart electrode for pacemaker or defibrillator$440.17
33286Removal of heart rhythm monitor from under the skin$112.40
33268Exclusion of appendage of left upper chamber of heart performed during$92.67
33274Insertion of permanent leadless pacemaker$421.36
33264Removal and replacement of multiple lead defibrillator$4811.78
33207Insertion of pacemaker and lower heart chamber electrode$592.59

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.