CPT® Code 33274

Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed

CPT® Code 33274 pertains to the transcatheter insertion or replacement of a permanent leadless pacemaker specifically into the right ventricle of the heart. This procedure is performed using a minimally invasive approach, which involves accessing the heart through the femoral vein. The use of imaging guidance, such as fluoroscopy, venous ultrasound, ventriculography, or femoral venography, is integral to the procedure, ensuring accurate placement of the pacemaker. A leadless pacemaker is a compact device that combines a pulse generator, battery, and electrode into a single unit, eliminating the need for traditional leads that connect to an external pulse generator. This innovation is particularly beneficial for patients who may have contraindications for lead placement, such as those with atrial fibrillation accompanied by atrioventricular (AV) block, or those requiring pacing due to sinus bradycardia or His-Purkinje System (HPS) disease. The procedure involves careful preparation of the groin area, accessing the femoral vein, and advancing a venous sheath to facilitate the delivery of the pacemaker into the right ventricle. Once positioned, the pacemaker undergoes evaluation to ensure proper function before the delivery system is removed. This code captures the comprehensive nature of the procedure, including the necessary imaging guidance and device evaluation, which are critical for successful implantation and patient outcomes.