Summary & Overview
HCPCS C2619: Pacemaker, Dual Chamber, Non Rate-Responsive (Implantable)
HCPCS Level II code C2619 designates an implantable dual-chamber, non rate-responsive pacemaker used to provide atrial and ventricular pacing without automatic rate modulation. This code is significant nationally because pacemaker implantation is a common cardiac device procedure with implications for hospital billing, device inventory, and post-implant follow-up care. Accurate coding affects device-specific claims, reimbursement classification, and clinical documentation.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations and payer inclusion, benchmark treatment and billing contexts, and relevant clinical context for device use. The publication outlines typical sites of service, common clinical indications in which a dual-chamber non rate-responsive pacemaker is used, and how the code maps to device implantation workflows.
The report provides national-level benchmarks where available, summarizes recent policy updates that affect device coding and claims processing, and offers clinical context to help billing and compliance teams align documentation with coding requirements. Data not available in the input is noted where applicable. This resource is intended to inform revenue cycle, coding professionals, and clinical program managers about the role and billing characteristics of HCPCS Level II code C2619 across major payers.
Billing Code Overview
HCPCS Level II code C2619 represents a pacemaker, dual chamber, non rate-responsive (implantable). This device provides electrical pacing to both the right atrium and right ventricle without automatic rate adaptation.
Service Type: Implantable cardiac pacemaker placement/device
Typical Site of Service: Inpatient hospital or ambulatory surgical center for device implantation
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with symptomatic bradycardia and documented symptomatic sinus node dysfunction is scheduled for implantation of a dual-chamber, non–rate-responsive implantable pacemaker. The typical workflow begins with outpatient cardiology evaluation including history, ECG, and ambulatory rhythm monitoring that demonstrates pauses or symptomatic chronotropic failure. Preoperative assessment includes medication review, anticoagulation plan, informed consent, and device selection. The procedure is performed in an electrophysiology or cardiac catheterization lab under monitored anesthesia care or general anesthesia. Venous access (usually subclavian or cephalic) is established, leads are placed in the right atrium and right ventricle, electrical measurements (sensing, pacing thresholds, and impedances) are checked, and leads are secured to the generator which is implanted in a subcutaneous or sub-pectoral pocket. Device programming is set to a fixed non–rate-responsive dual-chamber mode per the device description. Postoperative care includes chest x-ray, wound care, device interrogation, and short observation prior to discharge or brief inpatient stay for monitoring and management of anticoagulation or comorbidities.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, and complexity substantially exceed typical for pacemaker implantation and documentation supports increased work |