2025 CPT code 33238
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures - Cardiovascular System Surgery Feed
Removal of permanent transvenous electrode(s) via thoracotomy.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 59 for a distinct procedural service if performed in conjunction with other procedures). Consult the CPT manual for details.
Medical necessity is established when transvenous extraction attempts fail to remove the electrode, and the remaining lead poses a risk of infection, malfunction, or patient harm. The procedure is medically necessary to prevent further complications.
Thoracic surgeon or cardiovascular surgeon performs this procedure. Responsibilities include preparing the patient, performing the thoracotomy, carefully dissecting and removing the electrode, repairing the heart, controlling bleeding, and closing the chest incision.
- Surgery
- Cardiovascular System Procedures > Pacemaker and Implantable Cardioverter-Defibrillator Procedures > Electrode Removal
In simple words: This code describes a heart surgery where the doctor opens the chest to remove a permanent wire (electrode) from the heart's surface. This usually happens after the main device and other wires are removed in a previous surgery.
This CPT code, 33238, reports the surgical removal of permanent transvenous electrodes from the heart's surface using a thoracotomy.The procedure typically follows the removal of the generator and lead cutting in a prior procedure. It involves opening the chest wall, exposing the electrode attachment site on the heart, removing scar tissue, separating the electrode, repairing the resulting defect, controlling bleeding, and closing the chest wall incision.This is a surgical procedure requiring a thoracotomy (chest incision).
Example 1: A patient presents with a malfunctioning pacemaker, and after unsuccessful transvenous extraction of the lead, a thoracotomy is required to remove the problematic electrode., A patient has an infected pacemaker lead that cannot be removed transvenously, necessitating a thoracotomy for lead extraction., A patient requires removal of an old pacemaker lead prior to receiving a new device implant, and transvenous extraction fails, making thoracotomy necessary.
* Operative report detailing the thoracotomy, electrode removal technique, and any complications.* Preoperative and postoperative EKGs demonstrating the need for the procedure and successful outcome.* Imaging studies (e.g., chest X-ray) to assess lead placement and post-operative outcome.* Pathology report if any tissue is sent for analysis.* Consent form signed by patient.
** This procedure is complex and requires significant surgical skill.The use of this code should be reserved for cases where transvenous extraction is unsuccessful.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Cardiothoracic Surgery, Cardiac Electrophysiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center