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CPT 33206: Permanent Pacemaker Generator with Atrial Lead Insertion
CPT code 33206 denotes surgical insertion of a permanent pacemaker generator with implantation of one or more leads into the right atrium. This code captures a common cardiac electrophysiology procedure used to treat conduction disorders and atrial rhythm abnormalities that require long-term atrial pacing. Accurate coding of 33206 is important for clinical documentation, device registry tracking, and national procedure utilization metrics.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. The publication provides a national view of coding context, payer coverage considerations, and comparisons to related pacemaker insertion codes.
Readers will learn the clinical context for using 33206, how it differs from related pacemaker codes that involve ventricular or dual-lead placement, and which settings typically deliver the service. The report outlines common diagnosis associations and the expected site of service. It also highlights related codes for ventricular or combined atrial‑ventricular pacemaker insertions to aid correct code selection. Where available, benchmarks and payer coverage notes are summarized to inform billing accuracy and claims preparation. Data not available in the input is identified where applicable.
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Billing Code Overview
CPT code 33206 describes the insertion of a permanent pacemaker generator with implantation of one or more leads into the right atrium. The procedure is a surgical device implantation intended to provide long-term pacing support for patients with atrial conduction or rhythm disorders.
Service type: Device implantation — permanent pacemaker, atrial lead placement
Typical site of service: Hospital inpatient or outpatient surgical suite / cardiac catheterization lab
National Reimbursement Benchmarks
Medicare's mean rate is $406.2, substantially below BUCA's average commercial mean of $7,293.4, indicating a large gulf between federal reimbursement and the aggregate commercial network level. This gap highlights that services billed under CPT 33206 receive materially higher compensation in BUCA aggregate commercial arrangements than under Medicare.
Dispersion (P75 minus P25) varies notably by payer: Blue Cross Blue Shield shows the widest spread at $16,346.2 (P75 $18,041.5 minus P25 $1,694.8), followed by BUCA with a spread of $9,541.0 (P75 $10,664.1 minus P25 $1,123.1). Aetna and UnitedHealth Group are tighter at $418.9 and $510.4 respectively, while Cigna's spread is $491.4. Medicare's interquartile spread is narrow at $32 (P75 $424 minus P25 $392), reflecting the most compressed range among listed payers.