2025 CPT code 33207
Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Insertion or replacement of permanent pacemaker with transvenous electrode(s); ventricular
Modifiers may be applicable to this code. Modifier 51 (Multiple Procedures) may be used if other distinct procedures are performed during the same session. Modifier 22 (Increased Procedural Services) may be appropriate if the procedure is significantly more complex than usual.
Medical necessity must be clearly documented. This includes symptoms of bradycardia, heart block, or other arrhythmias. Diagnostic tests such as electrocardiograms (ECGs) and Holter monitoring results confirming the diagnosis should support the need for pacemaker placement.
The physician is responsible for prepping and anesthetizing the patient, making the incision for the pulse generator pocket and inserting the leads through a vein using imaging guidance, connecting the leads to the pulse generator and implanting the generator in the pocket and evaluating and programming the pacemaker.
In simple words: This procedure involves placing a device called a pacemaker under the skin, usually near the collarbone or in the abdomen. The pacemaker helps regulate the heartbeat.Small wires, called leads, are inserted through a vein and guided to the heart. These leads connect the pacemaker to the heart, allowing it to send electrical signals to help the heart beat regularly.
This code describes a procedure where a permanent pacemaker is either newly inserted or replaced, and one or more electrodes (leads) are placed transvenously into the right ventricle of the heart. The procedure involves creating a small incision, typically under the clavicle or in the abdomen, to create a pocket for the pulse generator. The leads are then inserted through a vein and guided to the right ventricle using imaging guidance. The leads are connected to the pulse generator, which is then placed in the prepared pocket. The device is then programmed and tested.
Example 1: A 70-year-old patient with symptomatic bradycardia and a history of heart failure requires a new ventricular pacemaker system., A 55-year-old patient with a previously implanted pacemaker experiences device failure, requiring replacement of the pulse generator and ventricular lead., A 60-year-old patient with an existing atrial pacemaker now requires upgrade to a dual-chamber system. During the procedure, the old generator is removed, and a new generator with a new ventricular lead is inserted.
Documentation should include the medical necessity for the procedure, such as ECG findings, patient symptoms, and any prior treatments. The operative report should detail the type of pacemaker system inserted, the location of the incision and pulse generator placement, the method of lead placement (transvenous), the number of leads inserted, any complications encountered, and the final device settings.
- RVU: 7.80