2025 CPT code 33235

Removal of transvenous pacemaker electrode(s); dual lead system.

Do not report 33235 in conjunction with device evaluation codes during the same session. Modifier 51 may be appended if performed with other distinct procedures.

Modifiers may be applicable. Modifier 22 may be used for increased procedural services, modifier 51 for multiple procedures, modifier 59 for distinct procedural service, and other modifiers as appropriate.

Medical necessity for this procedure should be supported by documentation of lead malfunction, infection, patient upgrade to new system, or other clinically appropriate reasons for lead removal.

The physician is responsible for prepping and anesthetizing the patient, making the incision, disconnecting the leads, dissecting the leads from scar tissue, extracting the leads, controlling bleeding, closing the pacemaker pocket, and post-operative care.

IMPORTANT Use 33234 for removal of a single lead. If the removal requires a thoracotomy due to unsuccessful transvenous extraction, use 33238 or 33243.

In simple words: This procedure removes two wires that connect a pacemaker to the heart. The doctor makes a small cut to access the area where the pacemaker is located, disconnects the wires, and carefully removes them. The area is then closed.

This code describes a procedure where two transvenous pacemaker electrodes (leads) are removed.These leads are typically inserted into a vein and advanced to the heart chambers. The procedure involves opening the pacemaker pocket, disconnecting the leads from the pulse generator, and carefully extracting them from the body.This may involve dissecting the leads from surrounding scar tissue.Bleeding control and closure of the pocket are also included.

Example 1: A patient with a dual-lead pacemaker system experiences lead malfunction and requires removal of both leads., A patient develops an infection around the pacemaker leads, necessitating removal of the dual-lead system., A patient requires an upgrade to a newer pacemaker system, and the existing dual leads are removed to make way for the new system.

Documentation should include operative report detailing the procedure, including the number of leads removed, method of extraction, any complications, and closure technique.Pre-operative imaging and indication for lead removal should also be documented.

  • Revenue Code: P2E
  • Payment Status: Active
  • Specialties:Cardiac Electrophysiology, Cardiothoracic Surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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