Summary & Overview
CPT 33276: Phrenic Nerve Stimulator System Implantation
CPT code 33276 covers the implantation of a phrenic nerve stimulator system, including placement of a pulse generator and one or more stimulating leads, plus associated vessel catheterization, imaging guidance, and pulse generator analysis/diagnostic activation when performed. This procedural code is relevant nationally for hospitals, ambulatory surgical centers, and cardiac or electrophysiology practices that perform neuromodulation for diaphragmatic pacing or phrenic nerve stimulation.
Key payers in the national context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers can expect a concise review of what 33276 represents clinically, typical settings where the service is delivered, and the payer landscape commonly encountered for device implantation procedures. The publication also summarizes common modifiers associated with device implant codes, highlights clinical context for phrenic nerve stimulation, and notes where input data were not provided.
This summary provides clinicians, billing staff, and policy analysts with essential background on the code, practical pointers on sites of service, and an outline of the payer mix addressed. Data not available in the input are clearly identified where applicable.
Billing Code Overview
CPT code 33276 describes the insertion of a phrenic nerve stimulator system, including placement of a pulse generator and one or more stimulating leads. The code encompasses all required vessel catheterization, imaging guidance, and pulse generator analysis and diagnostic activation if those elements are performed.
Service Type: Device implantation / surgical procedure involving neuromodulation for phrenic nerve stimulation.
Typical Site of Service: Hospital operating room or cardiac electrophysiology/catheterization lab; may also occur in ambulatory surgical centers equipped for implantable device procedures.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with chronic central hypoventilation or high cervical spinal cord injury causing diaphragmatic dysfunction and symptomatic hypoventilation despite optimized medical therapy. The patient has undergone multidisciplinary evaluation (pulmonology, neurology, and thoracic or cardiac electrophysiology) and testing including pulmonary function tests, arterial blood gas analysis, overnight oximetry or polysomnography, and imaging to confirm diaphragmatic paresis or dysfunction. The procedure 33276 is scheduled in an operating room or cardiac catheterization lab under general anesthesia or monitored anesthesia care. The provider implants a phrenic nerve stimulation system comprised of a pulse generator and one or more stimulating leads; intraoperative fluoroscopic or ultrasound guidance may be used for lead placement. Intraoperative testing includes pulse generator analysis and diagnostic activation of the leads to confirm appropriate diaphragmatic capture and ventilation support. Postoperative workflow includes device programming, chest radiography to confirm lead position, inpatient observation for respiratory status, and outpatient follow-up for device titration and long-term respiratory therapy coordination.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Not used for reporting; placeholder in input list when no modifier applied |