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    OpenPayerBilling CodesCardiac Implantation and Replacement ProceduresCPT cpt-0614t-substernal-implantable-defibrillator-pulse-generator-replacement
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    CPT 0614T: Substernal Implantable Defibrillator Pulse Generator Replacement

    CPT code 0614T describes removal of a substernal implantable cardioverter-defibrillator pulse generator from the existing chest wall pocket and replacement with a new pulse generator; this is a device replacement service typically performed in an operating room or procedure suite and is classified as surgical management of an implanted cardiac defibrillator.

    For related coverage guidance, see recent payer policy updates: Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA), Cardiovascular Disease Risk Assessment, Biomarkers for Myocardial Infarction and Chronic Heart Failure.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 65-year-old with a previously implanted substernal implantable cardioverter-defibrillator (ICD) pulse generator placed beneath the chest wall pocket for treatment of ventricular arrhythmias. Indications for generator replacement include elective replacement indicator (battery depletion), device malfunction, or upgrade to a new generator model. The procedure is performed in an operating room or cardiac electrophysiology lab under monitored anesthesia care or general anesthesia. The surgeon opens the existing chest wall pocket, removes the substernal pulse generator, inspects and preserves viable leads and lead connections, performs hemostasis and pocket irrigation, and implants a new generator in the same pocket. Device interrogation and programming occur intraoperatively to confirm lead integrity and appropriate sensing and defibrillation thresholds. Typical post-procedure workflow includes wound closure, sterile dressing application, postoperative device interrogation, brief monitoring in a recovery area or telemetry unit, and discharge instructions with follow-up device clinic appointment.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    33249Removal of permanent pacemaker pulse generator; replacement of pulse generator, same pulse generator systemOften used for replacement of transvenous pacemaker generators; clinically analogous when generator replaced in same pocket for transvenous systems.
    33258Removal of implantable defibrillator pulse generator; insertion of replacement pulse generator, same pulse generator systemDirectly related code for replacement of subcutaneous or transvenous ICD generators in typical locations; may be used for non-substernal pockets.
    33224Removal of subcutaneous implantable defibrillator pulse generator; replacement with a new subcutaneous generatorRelated when subcutaneous rather than substernal approach is used; addresses differences in device system.
    33233Insertion of new or replacement of transvenous ICD lead, single lead, with or without removal of old leadPerformed when lead revision or lead replacement is done at time of generator exchange.
    93288Programming device evaluation with iterative adjustment of parameters and/or cardioversion, with reprogramming and included follow-up interrogationUsed for extensive intraoperative and post-implant device programming and testing associated with generator replacement.

    Related Modifiers

    9 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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    225XH1200XHand Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers · Occupational Therapist
    207ZH0000XHematology (Pathology) PhysicianA hematopathologist is expert in diseases that affect blood cells, blood clotting mechanisms, bone marrow and lymph nodes. This physician has the know…
    364SP0807XChild & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    I21.3ST elevation (STEMI) myocardial infarction of unspecified site
    I21.9Acute myocardial infarction, unspecified
    I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris
    I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
    I46.9Cardiac arrest, cause unspecified
    I48.0Paroxysmal atrial fibrillation
    I48.91Unspecified atrial fibrillation
    I49.01Ventricular fibrillation
    I49.9Cardiac arrhythmia, unspecified
    I50.21Acute systolic (congestive) heart failure

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Cardiovascular Disease Risk Assessmentblue cross blue shield - louisiana2026-09-15
    Cardiovascular Disease Risk AssessmentBlue Cross Blue Shield - New Mexico2026-09-04
    Computed Tomography to Detect Coronary Artery CalcificationBluecross Idaho2026-09-01
    Intracoronary Drug Delivery Balloon ProceduresBlue Cross Blue Shield - Rhode Island2026-09-01
    Cardiac Imaging Guidelinesevicore2026-09-01
    Percutaneous Left Atrial Appendage Closure Device for Stroke PreventionAmbetter Georgia2026-08-26

    Related Codes

    CPT-0613T-INTERATRIAL-SEPTAL-SHUNT-INSERTION-TRANSCATHETER

    CPT 0613T: Percutaneous Interatrial Septal Shunt Implantation

    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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