Summary & Overview
CPT 33240: Implantable Cardioverter‑Defibrillator Pulse Generator Placement
CPT code 33240 represents the surgical placement of a new implantable cardioverter‑defibrillator (ICD) pulse generator into a subcutaneous pocket on the anterior chest in patients with an existing single‑chamber lead. Nationally, this service is critical for the management and prevention of life‑threatening arrhythmias and is performed in both inpatient and outpatient surgical settings. The procedure affects hospital, ambulatory surgery center, and device manufacturer workflows and carries implications for device management, perioperative care, and long‑term cardiac monitoring.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, standard billing considerations tied to the CPT code, and a summary of what to expect in payer coverage practice. The publication outlines benchmarks used in contracting and reimbursement discussions, common billing modifiers and coding considerations (listed separately), and policy developments that can affect coverage or payment for device replacement and generator implantation. Clinicians, billing professionals, and policy analysts will gain a clear national view of how CPT code 33240 is used, where it is typically performed, and which payers are commonly involved.
Billing Code Overview
CPT code 33240 describes the surgical placement of a new implantable cardioverter-defibrillator (ICD) pulse generator in a subcutaneous pocket on the anterior chest wall for a patient who already has a lead in one cardiac chamber. The device provides artificial regulation of heart rhythm and delivers therapies for life‑threatening arrhythmias.
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Service type: Implantation of an implantable cardioverter-defibrillator (pulse generator insertion)
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Typical site of service: Inpatient or outpatient surgical setting, commonly performed in an operating room or cardiac procedure suite
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with ischemic cardiomyopathy and a history of sustained ventricular tachycardia presents for replacement of a failed implantable cardioverter-defibrillator (ICD) pulse generator. The patient has an existing transvenous lead positioned in the right ventricle. Pre-procedure evaluation includes device interrogation confirming depleted battery and retained lead integrity, preoperative cardiac risk assessment, informed consent, and perioperative antibiotic prophylaxis. In the operating room or cardiac catheterization suite under monitored anesthesia care or general anesthesia, the provider creates or reopens a prepectoral subcutaneous pocket in the anterior chest, removes the old pulse generator if present, connects the existing single-chamber lead to the new ICD pulse generator, tests sensing and defibrillation thresholds, and programs the device prior to wound closure. Post-procedure workflow includes chest radiography if indicated, device interrogation, sterile dressing application, postoperative recovery monitoring for hemodynamic stability and wound complications, and discharge instructions with clinic follow-up for device checks.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Service not terminated or modifier not otherwise specified | Rare; used per payer if required as a default identification code |
11 |