Summary & Overview
CPT 0414T: CCM Pulse Generator Removal and Replacement
CPT code 0414T reports the removal of a cardiac contractility modulation (CCM) pulse generator from a previously created right upper chest pocket and placement of a new generator in the same or a different pocket. As an implantable cardiac device procedure, this code is relevant nationally for hospitals, ambulatory surgical centers, cardiology and electrophysiology practices, and payers managing device-related cardiac care. The code captures a discrete technical and surgical service tied to heart failure management and impacts device-related utilization and payment patterns across commercial and public payers.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service and typical sites of service, plus national benchmarking context where available. The publication outlines payment and coding considerations relevant to device exchange procedures, summarizes common modifiers used alongside device service codes, and highlights clinical context for CCM pulse generator replacement without reproducing specific patient diagnoses. Data not provided in the input are noted as unavailable. The content is intended to inform revenue cycle professionals, clinicians, and policy analysts about the clinical and billing profile of CPT code 0414T at a national level.
Billing Code Overview
CPT code 0414T describes the removal of a cardiac contractility modulation (CCM) pulse generator from a pocket previously created in the right upper chest and the placement of a new generator in the same or a new pocket. This procedure is a device revision and replacement service for implanted CCM systems used to treat heart failure symptoms by delivering non-excitatory electrical signals to the myocardium.
Service Type: Device removal and replacement (pulse generator exchange)
Typical Site of Service: Hospital operating room, inpatient setting, or ambulatory surgical center, depending on clinical status and facility capability.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with symptomatic heart failure with reduced ejection fraction and an existing cardiac contractility modulation (CCM) system presents with recurrent pocket pain and device malfunction identified on interrogation. The patient had the original CCM pulse generator implanted in the right upper chest. Preoperative assessment includes device interrogation, chest imaging to evaluate lead position and pocket anatomy, review of anticoagulation, and anesthesia evaluation. In the electrophysiology or cardiac surgery suite under monitored anesthesia care or general anesthesia, the operator opens the existing right upper chest pocket, disconnects and removes the old CCM pulse generator, inspects leads for integrity, and implants a replacement generator in the same pocket or creates a new pocket if needed. Intraoperative device testing confirms appropriate lead sensing and therapy delivery. The wound is irrigated and closed in layers, and the patient is recovered with post-procedure monitoring for hematoma, infection, lead dislodgement, and device function prior to discharge or observation admission.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced Services | When the service is partially reduced or eliminated at the physician's direction (e.g., limited generator replacement without full pocket revision). |
53 | Discontinued Procedure | When the procedure is started but discontinued due to patient instability or unexpected anatomical findings. |
62 | Two Surgeons | When two surgeons are required to perform distinct portions of the procedure (rare for generator replacement). |
66 | Surgical Team | When a surgical team (multiple surgeons with defined roles) performs the procedure. |
78 | Return to OR for Related Procedure During Global Period | For an unplanned return to the operating room for a related procedure during the global postoperative period (e.g., hematoma evacuation). |
79 | Unrelated Procedure or Service by the Same Physician During the Postoperative Period | When an unrelated procedure is performed during the global period (not listed among provided modifiers but commonly relevant). |
76 | Repeat Procedure by Same Physician | When the same physician performs a repeat procedure subsequent to the original (not in provided list; omitted). |
90 | Reference (Diagnostic) Lab (not applicable) | Not applicable but listed in some modifier sets (not in provided list). |
91 | Repeat Clinical Diagnostic Test (not applicable) | Not applicable to CPT 0414T. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Cardiovascular Disease (Cardiology) | Electrophysiologists or cardiologists who manage CCM devices and coordinate implantation and follow-up. |
| 207T00000X | Cardiac Electrophysiology | Specialists who perform device implantations and generator replacements. |
| 208100000X | Thoracic Surgery | Cardiac or thoracic surgeons may be involved for complex pocket revisions or reoperations. |
| 207P00000X | Internal Medicine (Hospitalist) | Manages perioperative medical care and optimization of heart failure medications. |
| 261QM0800X | Anesthesiology | Provides monitored anesthesia care or general anesthesia during the replacement procedure. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0414T | Removal of CCM pulse generator from existing right upper chest pocket and placement of new generator in same or new pocket | Primary procedure described: generator removal and replacement. |
33207 | Insertion of new or replacement of permanent pacemaker with transvenous electrodes; single lead | May be performed in patients requiring additional pacing support or when combined with device strategy adjustments. |
33208 | Insertion of new or replacement of permanent pacemaker with transvenous electrodes; two leads | Relevant if lead system modification is required during CCM generator replacement. |
33233 | Insertion of pacemaker pulse generator only; with existing leads | Analogous procedure for pacemaker generator change and clinically similar to CCM generator replacement when leads are preserved. |
93799 | Unlisted cardiovascular service or procedure | May be used for reporting uncommon, individualized device-related services not described by existing CPT codes. |