33270 Defibrillator implant Medicare reimbursement rates in New Jersey

This service covers placing or replacing a subcutaneous implantable cardioverter-defibrillator system, with the generator under the skin and an electrode positioned beneath the skin along the sternum. The physician also performs the system’s specified intraoperative testing, including arrhythmia induction and evaluation of defibrillation, sensing, or pacing function. Electrophysiologists and cardiac surgeons commonly perform the procedure in a hospital operating room or electrophysiology laboratory for patients who need protection from life-threatening ventricular arrhythmias and are receiving a subcutaneous rather than transvenous system.

Report 33270 for the complete system service, not when the work is limited to inserting an electrode. The operative report should identify whether the system was implanted or replaced, describe the subcutaneous generator and electrode placement, and document the testing performed. CMS assigns a 90-day global period; the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.