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CPT 36261: Revision of Implanted Catheter and Infusion Pump
CPT code 36261 represents a surgical revision in which a previously placed catheter and infusion pump are accessed and either repaired or replaced. This procedure is clinically significant because it addresses device malfunction, wear, infection, or other complications that can interrupt essential infusion therapy, affecting pain management, chemotherapy delivery, or chronic condition management. Nationally, such revisions are part of ongoing device maintenance and patient safety pathways that influence hospital surgical volumes and post-implant care protocols.
Key payers included in the national analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of typical clinical indications for revision, expected sites of service, and how payers commonly categorize and process this surgical service. The publication summarizes benchmarks where available, highlights notable policy updates affecting coverage and prior authorization practices, and provides clinical context relevant to surgical teams and billing professionals. Data not available in the input is clearly marked; where payer-specific reimbursement or utilization benchmarks are not supplied, readers are informed that such data was not available in the input. The goal is to equip clinicians, billing staff, and policy analysts with a clear understanding of the procedure, administrative considerations, and areas where payer policy may affect access and documentation requirements.
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Billing Code Overview
CPT code 36261 describes a surgical procedure in which a provider reopens a prior operative site to repair or replace an implanted catheter and infusion pump. This procedure involves accessing the existing pocket or catheter tract created during the original implantation to address malfunction, displacement, infection-related issues, or device replacement needs.
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Service type: Surgical revision of implanted catheter and infusion pump
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Typical site of service: Hospital operating room or ambulatory surgical center where implantable device revisions and hardware replacement are performed