CPT® Code 33236

The CPT® Code 33236 refers to the surgical procedure for the removal of a permanent epicardial pacemaker and its electrodes through a thoracotomy approach, specifically for a single lead system, which can be either atrial or ventricular. This procedure involves several critical steps, beginning with the opening of the pacemaker pocket where the epicardial electrode, also known as the lead or wire, is disconnected from the pacemaker generator. Following this, the generator itself is removed, and the pocket is subsequently closed to prevent complications. The thoracotomy, which is a surgical incision into the chest wall, can be performed using various approaches such as median sternotomy, subxiphoid, or subcostal, allowing the physician to gain access to the heart. Once the chest is opened, the heart is carefully exposed, and the epicardial pacemaker electrode is meticulously dissected free from any surrounding tissue that may have adhered to it along its path through the thorax and at its point of attachment to the pericardium. After the electrode is successfully removed, chest tubes may be placed as necessary to facilitate drainage, and the chest is then closed. This code is specifically applicable when a single lead system is being removed, while a different code, CPT® 33237, is designated for the removal of a dual lead system.