2025 CPT code 33221
(unknown) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Insertion of a pacemaker pulse generator only, with existing multiple leads.
Medical necessity must be supported by documentation indicating the clinical rationale for the pulse generator replacement (e.g., battery depletion, device malfunction, recall).
The physician is responsible for prepping and anesthetizing the patient, making the incision, creating the subcutaneous pocket, carefully connecting the existing leads to the new pulse generator, ensuring hemostasis, closing the incision, and programming the device.
In simple words: The doctor replaces the battery part of a pacemaker in a patient who already has several wires going to their heart.This procedure doesn't involve putting in any new wires, just replacing the part that powers the pacemaker.
This code describes the insertion of a new pacemaker pulse generator in a patient who already has multiple leads (three or more) in place. The procedure involves making an incision, creating a subcutaneous pocket, connecting the existing leads to the new generator, and programming the device.
Example 1: A patient with a triple-lead pacemaker system requires a generator replacement due to battery depletion. Code 33221 is used as the patient already has the leads in place., A patient with a previously implanted cardiac resynchronization therapy (CRT) device needs a new generator. If the existing leads are functional, 33221 would be reported for the generator replacement. , A patient has a multi-lead pacemaker system and the generator needs to be replaced due to a recall.As long as the leads are not being replaced, only the generator replacement is coded with 33221.
Documentation should include the type and number of existing leads, the reason for generator replacement, details of the procedure, including pocket creation and lead connection, device programming information, and any complications encountered.
** Radiological supervision and interpretation are included in 33221 if performed.