2025 CPT code 33270
(Active) Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Procedures Surgery Feed
Insertion or replacement of a permanent subcutaneous implantable cardioverter defibrillator (ICD) system with a subcutaneous electrode.
Modifiers may apply depending on the circumstances of the procedure. Consult the CPT manual and payer-specific guidelines for appropriate modifier use.
Medical necessity for a subcutaneous ICD is established based on the patient's history of life-threatening ventricular arrhythmias that are refractory to medical management.The procedure is deemed medically necessary to prevent sudden cardiac death.
The physician is responsible for pre-operative planning, including appropriate patient selection and risk assessment. During the procedure, the physician creates the device pocket, inserts and positions the electrode, connects it to the device, performs intraoperative testing (including defibrillation threshold testing if necessary), and programs the device according to the patient's needs.Post-operative care and follow-up are also the physician's responsibility.
In simple words: This code covers placing or replacing a device under the skin that helps control irregular heartbeats.It might also include tests to make sure the device works correctly and adjustments to its settings.
This CPT code encompasses the insertion or replacement of a permanent subcutaneous implantable cardioverter defibrillator (ICD) system, inclusive of a subcutaneous electrode.The procedure may also include defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters, as clinically indicated.Removal of a previously placed pulse generator and electrode is separately reportable.
Example 1: A 65-year-old male patient with a history of recurrent ventricular tachycardia undergoes implantation of a subcutaneous ICD with a single subcutaneous electrode.Defibrillation threshold testing and device programming are performed., A 72-year-old female patient with an existing subcutaneous ICD requires replacement of the pulse generator and electrode due to battery depletion.The procedure includes removal of the old system, implantation of the new system, and device programming., A 58-year-old male patient experiences lead fracture of his existing subcutaneous ICD requiring lead extraction and implantation of a new system. Defibrillation testing and programming are also performed.
Pre-operative assessment including patient history, physical examination, and relevant diagnostic testing (e.g., ECG, echocardiogram). Intraoperative documentation should include details of the incision site, electrode placement, device connection, testing results (including defibrillation thresholds if tested), and programming parameters. Post-operative documentation should include patient tolerance, device function verification, and instructions for patient care.
** This code should only be used for subcutaneous ICD systems.For substernal or transvenous ICD systems, other CPT codes are applicable.Always refer to the most recent CPT manual for the most up-to-date coding guidelines and definitions.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not applicable to this code.
- Specialties:Cardiology, Cardiac Surgery, Electrophysiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center