2025 CPT code 33233
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures - Cardiovascular System Surgery Feed
Removal of a permanent pacemaker pulse generator only.
Modifiers may apply depending on the circumstances of the service. Consult the CPT manual and payer-specific guidelines for appropriate modifier use.For instance, modifier 51 (multiple procedures) may apply if other procedures were performed during the same session.
Medical necessity for pulse generator removal is established by documented clinical findings indicating a need for removal, such as infection, malfunction of the pulse generator itself (excluding lead issues), or other compelling medical reasons. The existing clinical documentation must support the medical necessity.
The clinical responsibility lies with a cardiologist or cardiac surgeon. The physician will open the pacemaker pocket, carefully disconnect the pulse generator from the leads, remove the pulse generator, and close the incision.Appropriate anesthesia and sterile technique are required.
In simple words: The doctor removes the pacemaker's battery pack (pulse generator) from under the skin. The wires and leads to the heart remain in place.
This CPT code 33233 represents the surgical removal of a permanent pacemaker pulse generator without replacement or any other procedures on leads or other components. The procedure involves opening the cardiac device pocket, disconnecting the pulse generator from the leads, extracting the generator, and closing the pocket.No replacement pulse generator is inserted during this procedure.Any lead extractions or replacements are billed separately.
Example 1: A patient experiences a pacemaker malfunction, but the leads are functioning correctly.The pulse generator is removed, and a replacement pulse generator is scheduled for a later date., A patient develops an infection around the pacemaker pulse generator.The infected pulse generator is removed to allow for treatment of the infection. The leads are not infected and remain in place., A patient requires a pacemaker upgrade, but only the pulse generator needs to be replaced. The existing leads are compatible with the new pulse generator, therefore the surgeon removes the old pulse generator and implants the new one.
** Always cross-reference this code with the most current CPT guidelines and payer specific rules to ensure accurate billing.Understanding the specifics of the surgical procedure performed is critical for accurate coding.
- Revenue Code: P2E (Major Procedure, Cardiovascular - Pacemaker Insertion)
- RVU: The RVUs for this code will vary based on geographic location and other factors. Consult the CMS conversion factor and local payer guidelines for accurate reimbursement information.
- Global Days: Not applicable; this is a distinct procedure with no global surgical period.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Historical fee schedules are not readily available and vary by location and payer.Consult your local Medicare Administrative Contractor (MAC) for relevant historical data.
- Specialties:Cardiology, Cardiac Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center