Summary & Overview
CPT 33280: Phrenic Nerve Stimulator Pulse Generator Removal
CPT code 33280 denotes surgical removal of a phrenic nerve stimulator system’s pulse generator, including vessel catheterization, imaging guidance, and any interrogation or programming performed during the procedure. This code is relevant nationally for hospitals and ambulatory surgical centers that manage implanted neuromodulation devices used to treat diaphragmatic dysfunction and related indications. Proper coding for device explantation affects device registries, procedure tracking, and payer reimbursement workflows.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for phrenic nerve stimulator explantation, common sites of service, and the scope of services bundled into the code. The publication outlines typical billing considerations, frequently reported modifiers, and where gaps in publicly available mapping (taxonomies, associated diagnoses, and related codes) exist. The content is intended to support coding managers, revenue cycle professionals, and clinicians by clarifying what CPT code 33280 represents, why it matters for national billing and reporting, and what documentation elements are commonly associated with the procedural description. Data not available in the input for payer-specific rates or utilization benchmarks.
Billing Code Overview
CPT code 33280 describes removal of a phrenic nerve stimulator system pulse generator. The code includes all necessary vessel catheterization, imaging guidance, and interrogation and programming if performed. This procedure represents extraction of an implanted neuromodulation device component and encompasses associated intraoperative technical steps required for safe explantation.
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Service type: Surgical device removal / device explantation
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Typical site of service: Hospital operating room or ambulatory surgical center, depending on patient condition and clinical setting
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a previously implanted phrenic nerve stimulator for treatment of central sleep apnea presents months later with device malfunction and recurrent stimulation failure. After device interrogation confirms generator failure and imaging shows intact leads with adequate positioning, the clinical team schedules surgical removal of the pulse generator. The procedure typically occurs in an ambulatory surgical center or hospital operating room under monitored anesthesia care or general anesthesia. Preoperative workflow includes device interrogation and reprogramming attempts in the clinic or pre-op area, informed consent discussing risks of lead disturbance and infection, and standard preoperative assessment. Intraoperative steps include antiseptic skin preparation, incision and exposure of the subcutaneous pocket, disconnection and removal of the generator, evaluation of lead integrity, and imaging guidance or device interrogation as needed. The code encompasses all necessary vessel catheterization, imaging guidance, and interrogation/programming performed during the encounter. Postoperative workflow includes wound closure, dressing application, post-anesthesia recovery, device interrogation if leads remain, and discharge instructions with follow-up for wound check and device management decisions (replacement versus abandonment of leads).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard claim submission | Use for routine single-provider removal without special circumstances requiring a modifier. |