2025 CPT code 33230
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures - Cardiovascular System Procedures Surgery Feed
Insertion of an implantable defibrillator pulse generator only with existing dual leads.
Modifiers may apply depending on the circumstances of the procedure.Consult the CPT modifier guidelines for appropriate use.
The medical necessity for pulse generator replacement is based on the documented malfunction of the existing unit (battery depletion or other failure), requiring replacement to maintain the patient's cardiac rhythm management.
The physician is responsible for the incision, preparation of the pocket, insertion of the pulse generator, connection to existing leads, testing, hemostasis, closure, and device programming.Anesthesiologist or other qualified personnel might handle sedation/anesthesia.
In simple words: The doctor puts in a new battery and computer part for a device already implanted in the chest to help the heart beat regularly. The wires that connect to the heart were already there.
This CPT code represents the insertion of a new implantable cardioverter-defibrillator (ICD) pulse generator into a pre-existing subcutaneous pocket, assuming dual leads are already in place.The procedure involves preparing the existing pocket, possibly incising and cleaning it, and then placing the new pulse generator, connecting it to the existing dual leads, testing functionality, achieving hemostasis, and closing the pocket.The device is then programmed for optimal functionality. This does not include the insertion or replacement of leads.
Example 1: A patient with an existing dual-lead ICD system requires a pulse generator replacement due to battery depletion. The existing leads are functional. Code 33230 is used., A patient has a malfunctioning ICD pulse generator, but the leads are fully functional.The cardiologist replaces the pulse generator only using code 33230., Post-operative infection around the generator necessitates the removal and replacement of the pulse generator in a patient with a previously implanted dual-lead ICD system. 33230 is utilized after removal of the old generator.
** Always cross-reference with the most recent CPT and NCCI guidelines before coding to ensure accurate reimbursement.This information is for guidance and may not cover all possible scenarios.
- Revenue Code: 0274 (Cardiac Devices)
- RVU: This will vary by payer and location. Consult your local Medicare Administrative Contractor (MAC) or private payer fee schedules for the most up-to-date RVU values and conversion factors.
- Global Days: This code likely falls under a global surgical period; the specific duration should be determined by the payer's guidelines.
- Payment Status: Active
- Modifier TC rule: This code is not applicable to Technical Component (TC) modifiers.
- Fee Schedule: Historical fee schedule data can be obtained from CMS and private payer websites.These data are subject to change.
- Specialties:Cardiology, Cardiac Surgery, Electrophysiology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center