CPT 33249 Surgery - Cardiovascular

How Much Does Insertion Of/rplcmt Defib with Lead(s) Cost?

Also known as: Insj/rplcmt defib w/lead(s) (CPT 33249)

Implantation of an implantable cardioverter-defibrillator (ICD) that can shock your heart back to a normal rhythm if a dangerous arrhythmia occurs.

The total estimated cost of Insertion Of/rplcmt Defib with Lead(s) (CPT 33249) is $2,681 to $5,028, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $798.

Total Estimated Cost of Care

$2,681 — $5,028

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$798
Hospital Facility Fee
$2,394
Anesthesia (est.)
$160
Important: The physician fee of $798 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$798
Physician component only — CMS PFS 2026

Patient Guide: Insertion Of/rplcmt Defib with Lead(s)

What you need to know before your appointment

What to Expect

Under sedation, a device slightly larger than a pacemaker is implanted under your skin. Leads are threaded to your heart. The ICD monitors your rhythm and delivers a shock if it detects a life-threatening irregular heartbeat.

How Long Does It Take?

1-3 hours of surgery

Common Reasons Doctors Order This

Cardiac arrest survivor, dangerous heart rhythms (ventricular tachycardia/fibrillation), severely weakened heart muscle, high risk of sudden cardiac death

How to Prepare

Fast after midnight. You will stay in the hospital for 1-2 days. Avoid heavy lifting and raising the arm above your shoulder for 4-6 weeks. You will receive a device identification card.

Procedures Commonly Done Together

These procedures are frequently performed alongside Insj/rplcmt defib w/lead(s)

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How to Reduce Your Cost for Insj/rplcmt defib w/lead(s)

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

14.55
Work RVU
5.91
Practice Expense RVU
3.43
Malpractice RVU
23.89
Total RVU

Payment = Total RVU (23.89) x CF ($33.40) = $798

Frequently Asked Questions

How much does Insj/rplcmt defib w/lead(s) cost?

The Medicare facility rate for Insj/rplcmt defib w/lead(s) is $798. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Insj/rplcmt defib w/lead(s) cost without insurance?

Without insurance, the cost of Insj/rplcmt defib w/lead(s) can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Insj/rplcmt defib w/lead(s)?

Most commercial health insurance plans and Medicare cover Insj/rplcmt defib w/lead(s) when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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