Summary & Overview
CPT 0925T: Relocation of Cardiac Pulse Generator Pocket
CPT code 0925T is a recently defined code for relocation of the skin pocket containing the pulse generator of a cardiac contractility modulation–defibrillation system. The code captures a targeted surgical intervention to reposition an implanted cardiac device generator and its pocket, a procedure that affects device longevity, infection risk, patient comfort, and downstream device management. Nationally, this service is relevant for cardiology, electrophysiology, and cardiac surgery programs managing complex device patients.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical and operational context for the procedure, typical sites of service, and the scope of services represented by the code. The publication outlines expected use cases, common modifiers, and the role of this code within device management workflows.
The report provides benchmarks and policy-oriented context where available, clarifies clinical indications that commonly prompt pocket relocation, and summarizes payer coverage considerations and documentation elements that influence coding and claims processing. Data not available in the input is noted explicitly where relevant.
Billing Code Overview
CPT code 0925T describes a surgical procedure in which the provider relocates the skin pocket that houses the pulse generator of a cardiac contractility modulation–defibrillation system. This service involves repositioning the implanted pulse generator and its subcutaneous pocket to a new location on the patient's chest to address issues such as device discomfort, skin breakdown, infection risk, or lead management concerns.
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Service type: Surgical implantation/relocation of cardiac device pocket
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Typical site of service: Inpatient or outpatient hospital setting, or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a previously implanted cardiac contractility modulation–defibrillation (CCM‑ICD) system who presents with pocket‑related issues such as pain, device erosion risk, malposition, recurrent pocket infection, device migration, or cosmetic concerns. The patient often has heart failure with reduced ejection fraction and an implantable combined pulse generator placed subcutaneously or submuscularly in the chest. Prior to relocation, the clinical workflow includes preoperative evaluation (history, device interrogation, recent imaging such as chest radiograph or ultrasound to assess pocket and lead positions), perioperative antibiotic prophylaxis per institutional protocol, informed consent addressing risks of device relocation and lead integrity, and coordination with electrophysiology and cardiothoracic services.
In the operating room or procedure suite, the team typically includes an electrophysiologist or cardiothoracic surgeon, anesthesiology (local with sedation or general anesthesia depending on complexity), device representative for programming support, and surgical nursing. The procedure consists of incision and dissection of the existing pocket, careful relocation of the pulse generator to a new subcutaneous or submuscular pocket, securing the generator in the new pocket, testing and reconnecting leads if needed, device interrogation and reprogramming, hemostasis, and layered closure. Postoperative workflow includes device interrogation, wound monitoring, pain management, and discharge instructions with follow‑up for wound check and remote device monitoring setup as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or intensity substantially exceeds typical for pocket relocation and documentation supports increased services. |
23 | Unusual anesthesia | Use when general anesthesia is provided for reasons not usually necessary for the procedure (e.g., severe anxiety, inability to cooperate). |
52 | Reduced services | Use when the procedure is partially completed or curtailed but not fully abandoned. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances or patient safety. |
62 | Two surgeons | Use when two surgeons with different specialties work together as primary surgeons for a single complex relocation. |
66 | Surgical team | Use when a surgical team (multiple surgeons) performs the procedure per payer rules. |
78 | Return to OR for related procedure during postoperative period | Use for unplanned return to the operating room for a related procedure such as hematoma evacuation or pocket revision within the global period. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during the global period (not listed in the raw modifiers but commonly relevant—excluded from selection per instructions). |
73 | Discontinued outpatient procedure prior to anesthesia administration | Use when the relocation is cancelled after initiation of preoperative preparation but before anesthesia/sedation. |
80 | Assistant surgeon | Use when a trained assistant surgeon performs portions of the operation under the primary surgeon's direction. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Cardiac Electrophysiology | Electrophysiologists most commonly perform CCM‑ICD device implantation and pocket revisions. |
| 207RH0000X | Cardiac Surgery | Cardiothoracic surgeons may perform relocation for complex revisions or when lead or vascular issues require surgical access. |
| 207RR0500X | Cardiology | Interventional/noninvasive cardiologists with device training may be involved in device management and interrogation. |
| 208D00000X | Family Medicine | May provide preoperative and postoperative medical management in coordination with specialists. |
| 208C00000X | Internal Medicine | Often manages comorbidities and perioperative medical optimization. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. | Data not available in the input. | Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
33249 | Insertion or replacement of pulse generator only, single lead system | Used for generator replacement procedures which may precede or follow pocket relocation when device replacement is required. |
33240 | Removal of implanted pacemaker or cardioverter‑defibrillator pulse generator with replacement, single lead system | Relevant when device removal and replacement occur in the same setting as pocket relocation. |
33235 | Revision or relocation of pacemaker or implantable defibrillator pocket without generator change | Directly related procedure; similar pocket manipulation and relocation techniques apply. |
33216 | Insertion or replacement of permanent pacemaker lead, atrial and/or ventricular | Performed if lead repositioning or replacement is required during pocket relocation. |
36600 | Arterial catheterization or cannulation for sampling, monitoring or transfusion (not diagnostic) | May be performed perioperatively for hemodynamic monitoring in medically complex patients undergoing relocation. |
69210 | Removal of foreign body, external auditory canal (example only) | Data not available in the input. |