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    v1.0.28
    OpenPayerBilling CodesSurgical, Imaging Devices and GraftsHCPCS hcpcs-c1605-leadless-dual-chamber-pacemaker-implantation
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    HCPCS C1605: Leadless Dual-Chamber Pacemaker Implantation

    HCPCS Level II code C1605 describes a leadless dual-chamber pacemaker system (right atrial and right ventricular implantable components), rate-responsive, including all components required for implantation; service type is implantation of a leadless dual-chamber pacemaker, and the typical site of service is inpatient or outpatient cardiac electrophysiology procedure suite where device implantation and testing are performed.

    For related coverage guidance, see recent payer policy updates: Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing), Hip Arthroplasty (partial and total hip replacement), Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty).

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an older adult with symptomatic bradyarrhythmia or conduction disease who presents for implantation of a leadless dual‑chamber pacemaker system. The patient commonly has intermittent syncope, presyncope, fatigue, or documented sinus node dysfunction and atrioventricular block on ambulatory monitoring or telemetry. Preoperative evaluation includes history, focused cardiac exam, 12‑lead ECG, transthoracic echocardiogram as indicated, laboratory studies, and assessment of vascular access. The implantation occurs in a cardiac catheterization laboratory or hybrid electrophysiology (EP) suite under conscious sedation or general anesthesia depending on patient comorbidity and procedural complexity. The procedural workflow includes vascular access (typically femoral venous), intracardiac mapping and positioning of the right atrial and right ventricular leadless components, device deployment and electrical testing, device programming (rate‑responsive settings), hemostasis and recovery monitoring. Post‑procedure care includes telemetry observation, wound care at access site, device interrogation prior to discharge, and follow‑up in device clinic for programming and remote monitoring enrollment.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    33207Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricularAlternative or adjunct when a transvenous dual‑chamber system is used instead of leadless components.
    33208Revision or replacement of pacemaker lead, single or dual leadUsed when lead adjustments or replacements are required in hybrid or conversion procedures.
    33233Removal of permanent pacemaker system including leads (partial or complete)Used when explantation of an existing device is performed prior to or during leadless system implantation.
    93279Interrogation device evaluation (clinic or remote) for pacemaker, up to 10 minutesUsed for device interrogation in the clinic or remotely as part of follow‑up.
    33224Insertion of temporary transvenous pacemaker electrode, including connection to external generatorUsed in peri‑procedural management for hemodynamically unstable patients requiring temporary pacing support.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    156FX1700XOcularistAn ocularist is a thoroughly trained professional skilled in the art of fitting, painting, and fabricating custom ocular prostheses. In addition to cr…
    2278E1000XEducational Certified Respiratory TherapistThe focus of patient and family education activities is to promote knowledge of disease process, medical therapy, and self help. Respiratory therapis…
    364SP0807XChild & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    174200000XMeals ProviderA public or privately owned facility providing meals to individuals traveling long distances or receiving prolonged outpatient medical services away f…

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 2

    10 rows

    PolicyPayerEffective Date
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Sacroiliac Joint Fusion or Stabilizationuniverahealthcare2026-10-15
    Percutaneous Vertebroplasty/Mechanical Vertebral Augmentation and Percutaneous Sacroplastyuniverahealthcare2026-10-15
    Autologous Chondrocyte Implantation (ACI)univerahealthcare2026-10-15
    Shoulder Open ProceduresPremera Bluecross2026-09-04

    Related Codes

    HCPCS-C1600-INTRAVASCULAR-LESION-PREPARATION-BLADED-CATHETER

    HCPCS Level II C1600: Transluminal Lesion Preparation Bladed Sheathed Catheter

    HCPCS-C1601-DISPOSABLE-PULMONARY-ENDOSCOPE-IMAGING

    HCPCS Level II C1601: Single-Use Pulmonary Imaging/Illumination Endoscope

    HCPCS-C1602-ABSORBABLE-ANTIMICROBIAL-BONE-VOID-FILLER-IMPLANTABLE

    HCPCS C1602: Absorbable Antimicrobial-Eluting Bone Void Filler

    HCPCS-C1603-IVC-FILTER-RETRIEVAL-LASER-DEVICE

    HCPCS Level II C1603: Laser Retrieval Device for IVC Filter

    HCPCS-C1604-TRANSMURAL-TRANSVENOUS-ARTERIAL-BYPASS-GRAFT-IMPLANTABLE

    HCPCS C1604: Graft, Transmural Transvenous Arterial Bypass (Implantable)

    HCPCS-C1606-ENDOSCOPIC-ULTRASOUND-ADAPTER-DISPOSABLE

    HCPCS C1606: Adapter for Ultrasound Attachment to Upper GI Endoscope

    HCPCS-C1607-IMPLANTABLE-RECHARGEABLE-NEUROSTIMULATOR-INTEGRATED

    HCPCS Level II C1607: Implantable Rechargeable Neurostimulator

    HCPCS-C1608-TOTAL-DUAL-MOBILITY-FIRST-CARPOMETACARPAL-PROSTHESIS

    HCPCS Level II C1608: Total Dual Mobility Prosthesis, First CMC Joint

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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