Question:

What code should be assigned when a battery is replaced for a pacemaker?

Answer:

When a “battery” is replaced, it is actually the pulse generator that is being replaced. Hybrid codes have been created for the exchange. These codes include the removal and replacement of the battery only during the same encounter when chronic leads are used.

For example:

For exchange of single-lead pulse generator:

33227 Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system

For outpatient prospective payment system (OPPS) billing, add the HCPCS code for the implanted device:

C2620 Single-chamber pacemaker, non rate-responsive (implantable)

Or

C1786 Single-chamber pacemaker, rate-responsive (implantable)

For the dual-lead pulse generator:

33228 Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system

For OPPS billing, add the HCPCS code for the implanted device:

C2619 Dual chamber pacemaker, nonrate-responsive (implantable)

Or

C1785 Dual chamber pacemaker, rate-responsive (implantable)

For the multiple-lead pulse generator:

33229 Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system

For OPPS billing, add the HCPCS code for the implanted device:

C2621 Pacemaker, other than single or dual chamber (implantable)

The parenthetical under codes 33227, 33228, 33229 states:

(Do not report 33227, 33228, 33229 in conjunction with 33214, 33216, 33217, 33233)

(For removal and replacement of pacemaker pulse generator and transvenous electrode(s), use 33233 in conjunction with either 33234 or 33235 and 33206 – 33208)


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CPT is a registered trademark of the American Medical Association.