Summary & Overview
CPT 33207: Permanent Pacemaker Insertion, Right Ventricular Lead
CPT code 33207 denotes the surgical insertion or replacement of a permanent pacemaker with implantation of one or more electrodes into the right ventricle. This code captures a common cardiac electrophysiology procedure used to treat bradyarrhythmias and conduction disorders by providing durable ventricular pacing. Nationally, pacemaker implantation is a high-impact procedure for inpatient and outpatient cardiovascular care, affecting hospital resource use, device supply chains, and payer coverage policies.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for CPT code 33207, typical sites of service, and which payers commonly reimburse the procedure. The publication outlines benchmark measures and payment considerations relevant to facilities and clinicians, and highlights recent policy updates affecting coding and coverage where applicable.
The report also provides practical billing context: common modifiers associated with surgical and facility billing, service line placement, and notes on ancillary coding elements. Where specific data points are not included in the input, the publication indicates that data are not available in the input. This resource is intended to inform coding, billing, and administrative stakeholders about the clinical purpose and typical billing environment for CPT code 33207.
Billing Code Overview
CPT code 33207 describes the insertion or replacement of a permanent pacemaker with implantation of one or more electrodes into the right ventricle. This procedure involves placement of a durable cardiac rhythm device to provide electrical stimulation to the heart when intrinsic conduction is inadequate.
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Service type: Surgical implant of a permanent cardiac pacemaker lead(s) into the right ventricle
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 78-year-old patient with symptomatic bradycardia and episodes of syncope is evaluated in the cardiology clinic. Noninvasive testing including 12-lead ECG and ambulatory monitoring demonstrates persistent sinus node dysfunction with pauses and symptomatic heart rates below 40 beats per minute. The electrophysiology team schedules the patient for implantation of a single- or dual-lead permanent transvenous pacemaker. On the day of service, the patient arrives to the hospital-based cardiac catheterization laboratory or electrophysiology (EP) suite after preoperative evaluation and informed consent. Under monitored anesthesia care or general anesthesia per the anesthesia team and proceduralist preference, vascular access is obtained (typically via the subclavian or cephalic vein). One or more transvenous pacing leads are advanced under fluoroscopic guidance and positioned in the right ventricle. The pacemaker generator pocket is created in the subcutaneous tissue of the left or right subclavian area. Leads are connected to the generator, lead parameters are tested and programmed, hemostasis is secured, and the pocket is closed. Post-procedure, the patient is observed in a recovery area and undergoes chest radiography to confirm lead position and rule out pneumothorax prior to discharge or admission for observation. This workflow reflects the service described by 33207, insertion or replacement of a permanent pacemaker with implantation of one or more electrodes into the right ventricle.
Coding Specifications
| Modifier | Description | When to Use |
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