HCPCS C1740: Leadless Electrode and Battery for Left Ventricular Pacing

HCPCS Level II code C1740 denotes an implantable leadless electrode, transmitter and battery system used for sequential left ventricular pacing. The code represents a specialized cardiac implant designed to provide targeted pacing of the left ventricle, an important option in cardiac resynchronization and management of certain heart rhythm disorders. Nationally, such devices affect hospital and outpatient procedural billing, device supply chains, and cardiac device utilization patterns.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise overview of the code’s clinical purpose and typical settings of implantation, an explanation of what benchmarks and coverage items are commonly examined for implantable cardiac devices, and context on coding relationships that influence reimbursement and facility billing. The publication outlines where C1740 fits within device-based cardiac care and what aspects of policy and billing readers should monitor.

The report covers: code definition and clinical context; typical sites of service and service type; payer coverage landscape and common contractual considerations; and areas for further review such as claims bundling, device supply reporting, and hospital outpatient payment impacts. Data not available in the input is noted where applicable.

Billing Code Overview

HCPCS Level II code C1740 describes a leadless electrode, transmitter, battery (all implantable), for sequential left ventricular pacing. This device is intended for implantation to provide sequential left ventricular pacing as part of cardiac rhythm management therapy.

Service type: Implantable cardiac device — left ventricular pacing system

Typical site of service: Inpatient or outpatient hospital setting or ambulatory surgical center where device implantation and generator placement for cardiac pacing are performed

Data not available in the input.

Clinical Context

A 76-year-old patient with a history of ischemic cardiomyopathy and persistent symptomatic heart failure despite guideline-directed medical therapy is evaluated for device-based cardiac resynchronization. The patient has chronic atrial fibrillation with a slow ventricular response and prior infections at transvenous device sites, making a conventional transvenous left ventricular lead high risk. A multidisciplinary heart team (electrophysiology, cardiac anesthesia, and implant nursing) determines the patient is a candidate for implantation of a leadless electrode, transmitter, and battery system for sequential left ventricular pacing (C1740). The clinical workflow includes pre-procedure imaging (echocardiography, chest radiograph), device selection and consent, pre-op antibiotic prophylaxis, intraoperative device implantation in a cardiac catheterization or hybrid operating room under monitored anesthesia care or general anesthesia, device programming and interrogation, post-procedure monitoring for hemodynamic stability and device function, and discharge planning with outpatient device clinic follow-up for remote monitoring and longitudinal pacing optimization.

Coding Specifications

Modifier	Description	When to Use
`51`	Multiple Procedures	When the leadless left ventricular pacing system implantation is one of multiple distinct procedures performed the same day and payer allows modifier .

Taxonomy Code	Specialty	Notes
`207RH0000X`	Cardiovascular Disease - Cardiac Electrophysiology	Electrophysiologists who perform device implantation and programming.
`207RC0000X`	Interventional Cardiology	Cardiologists involved in device selection and peri-procedural management in hybrid settings.
`2084P0800X`	Cardiovascular Surgery	Cardiothoracic surgeons for hybrid or surgical access implantation scenarios.
`363L00000X`	Registered Nurse - Anesthesiology	Perioperative anesthesia team members providing conscious sedation or monitored anesthesia care.
`363A00000X`	Physician Assistant	PAs who may assist in implantation and peri-procedural management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.22`	Chronic systolic (congestive) heart failure	Left ventricular pacing can provide resynchronization therapy benefit in patients with reduced ejection fraction and chronic systolic dysfunction.
`I50.32`	Chronic diastolic (congestive) heart failure	Some patients with combined heart failure phenotypes may be evaluated for device therapy when symptomatic despite therapy.
`I48.0`	Paroxysmal atrial fibrillation	Atrial fibrillation often coexists and influences pacing strategy and device selection, including leadless systems.
`I48.2`	Chronic atrial fibrillation	Persistent or permanent atrial fibrillation may favor ventricular-based pacing strategies and leadless options.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	Ischemic cardiomyopathy from coronary disease is a common underlying etiology for ventricular dysfunction and CRT consideration.
`Z45.019`	Encounter for adjustment and management of automated implantable cardiac device, unspecified	Used for postoperative device programming, interrogation, and follow-up management related to implanted pacing systems.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33208`	Insertion of pacemaker pulse generator only; transvenous single chamber (atrial or ventricular)	May be performed in patients requiring conversion from conventional systems or when only generator placement is needed as part of the device strategy.
`33217`	Insertion of new or replacement of permanent pacemaker with transvenous lead(s); single chamber ventricular system (implantable)	Related transvenous pacing procedures that may be alternatives to a leadless left ventricular system.
`33249`	Insertion or replacement of permanent pacemaker with transvenous dual chamber system	Represents conventional CRT or dual-chamber pacing procedures considered in device selection.
`33285`	Insertion or replacement of pacemaker pulse generator with existing transvenous lead(s); complex generator changes including cardiac resynchronization therapy (CRT) features	Generator changes or upgrades to CRT-capable systems that may be performed when converting between systems.
`92970`	Percutaneous transluminal coronary angioplasty; single major coronary artery, each branch — diagnostic/therapeutic when coronary access is required	Occasionally performed prior to or during implantation in hybrid cases requiring coronary access or assessment (used selectively in combined procedures).

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Summary & Overview