A patient undergoes an initial insertion of a dual-chamber pacemaker system. An RA lead is implanted. In the RV, 2 leads are implanted – 1 at the apex and 1 at the His bundle. Would this be coded with 33208 only, since the code description contains the word “electrode(s)”? Or, can 33999 be added to 33208 to represent the extra lead/extra work involved?


When an RA and RV lead is placed in addition to the generator, code 33208. If an additional RV lead is placed at the HIS for LV support, code 33999 in addition. This additional lead is being placed usually if the left coronary sinus can’t be accessed.


CPT® copyright 2021 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.