Insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber

CPT 33249 is the billing code for "Insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber". For insertion or replacement of permanent pacing cardioverter-defibrillator (ICD) system

Medicare pays approximately $870.77 for CPT 33249 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 33249 has a total RVU of 51.55, broken down as: Work RVU 22.50, Practice Expense RVU 26.80, and Malpractice RVU 2.25. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 33249 include: Indication for ICD; ICD type and model; Lead placement location; Defibrillation threshold testing. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 33249: Includes ICD insertion or replacement. Includes lead placement Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 33249 include: 22 (Increased procedural services for complex cases), 51 (Multiple procedures performed same session), 52 (Reduced services if procedure not completed). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 33249 is 90-120 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.