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    v1.0.30
    OpenPayerBilling CodesImplantable Cardioverter-Defibrillator with Substernal ElectrodeCPT cpt-0574t-substernal-defibrillator-electrode-repositioning
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    CPT 0574T: Substernal Implantable Defibrillator Electrode Reposition and Attachment

    CPT code 0574T describes the repositioning of a previously placed substernal implantable defibrillator–pacing electrode and its attachment to a pulse generator; this procedure is a surgical repositioning of a defibrillator/pacing lead when subcutaneous or transvenous electrode placement is not feasible, performed in an operating room or procedural suite as a surgical lead revision/repositioning service for management of implantable cardioverter-defibrillator (ICD) systems.

    For related coverage guidance, see recent payer policy updates: Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with ischemic cardiomyopathy and recurrent ventricular tachycardia presents after prior attempts at subcutaneous and transvenous lead placement were deemed infeasible due to limited vascular access and infection risk. The electrophysiology team schedules the patient for a procedure to reposition a previously placed substernal implantable defibrillator–pacing electrode and attach it to a pulse generator. Typical workflow includes preoperative device interrogation and imaging review, informed consent discussing risks of bleeding, infection, lead displacement, and device malfunction, perioperative antibiotic prophylaxis, procedural anesthesia (general or monitored anesthesia care), surgical exposure of the substernal pocket and generator site, careful dissection to locate the previously tunneled substernal electrode, lead assessment and repositioning as needed, secure attachment to the pulse generator, intraoperative device testing including sensing and defibrillation threshold testing as indicated, wound closure, and postoperative device programming and chest radiograph to document lead position. Typical site of service is an operating room or cardiac electrophysiology procedure suite in an acute care hospital. Typical patient scenario: symptomatic ventricular arrhythmia or device malfunction in a patient with limited venous access, prior device infection, or anatomical considerations making substernal electrode the optimal approach.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    33207Insertion or replacement of permanent pacemaker with transvenous electrode(s); single lead, with subcutaneous pocketMay be performed when transvenous pacing is feasible or in initial device implantation workflows.
    33208Insertion or replacement of permanent pacemaker with transvenous electrode(s); two leadsRelated when pacing needs require additional lead configuration versus substernal approach.
    33249Insertion or replacement of implantable cardioverter-defibrillator, single lead, transvenousAlternative device implantation technique if transvenous lead placement is possible.
    33262Insertion or replacement of implantable cardioverter-defibrillator (ICD), epicardial or subcutaneous lead system, with pulse generatorRelated for subcutaneous or epicardial systems; part of differential approach to lead placement.
    0570TSubsternal implantable defibrillator–pacing electrode placement, initial placementCommonly performed before 0574T when the electrode is initially placed; 0574T describes repositioning of a previously placed substernal electrode.
    33235Revision or removal of transvenous pacemaker or ICD lead(s)Performed when lead extraction, revision, or replacement is required in the device management workflow.

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    208000000X
    363L00000X
    363A00000X
    320600000X
    246XC2903X
    225C00000X
    2080S0012X

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure - Medical PolicyHealth-New-England2027-02-01
    Transcatheter Mitral Valve Repair Medical PolicyHealth-New-England2027-02-01
    Cardiac Electrophysiological (EP) Studies and Cardiac Ablation of Abnormal Electrical RhythmsCigna2027-01-15
    Outpatient Cardiology Procedures for EviCore Arrangement (for Oxford Only)Colorado Rocky Mountain Health Plans2026-11-01
    Biomarkers for Myocardial Infarction and Chronic Heart Failure Reimbursement PolicyHealthfirst2026-11-01
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2026-11-01
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2026-11-01

    Related Codes

    CPT-0571T-SUBSTERNAL-ICD-IMPLANTATION-REPLACEMENT

    CPT 0571T: Substernal ICD Implantation or Replacement

    CPT-0572T-SUBSTERNAL-IMPLANTABLE-DEFIBRILLATOR-ELECTRODE-PLACEMENT

    CPT 0572T: Substernal Implantable Defibrillator Electrode Insertion

    CPT-0573T-SUBSTERNAL-DEFIBRILLATOR-ELECTRODE-REMOVAL

    CPT 0573T: Substernal Implantable Defibrillator Electrode Removal

    CPT-0575T-ICD-PROGRAMMING-EVALUATION-ADJUSTMENT

    CPT 0575T: ICD In-Person Programming and Optimization

    CPT-0576T-ICD-INTERROGATION-AND-EVALUATION-IN-PERSON

    CPT 0576T: In-Person ICD System Interrogation and Evaluation

    CPT-0577T-SUBSTERNAL-ICD-SYSTEM-ELECTROPHYSIOLOGIC-EVALUATION-AND-PROGRAMMING

    CPT 0577T: ICD System Evaluation and Programming with Substernal Electrode

    CPT-0578T-REMOTE-SUBSTERNAL-LEAD-ICD-FUNCTION-ANALYSIS-90-DAY

    CPT 0578T: Remote Analysis of Substernal-Lead ICD Function, Up to 90 Days

    CPT-0579T-REMOTE-ICD-INTERROGATION-TECHNICIAN-90-DAY

    CPT 0579T: Remote ICD Interrogation and Technician Evaluation, up to 90 Days

    CPT-0580T-SUBSTERNAL-IMPLANTABLE-DEFIBRILLATOR-PULSE-GENERATOR-REMOVAL

    CPT 0580T: Substernal Implantable Defibrillator Pulse Generator Removal

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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