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Are the CPT codes for transcutaneous and transvenous pacing the same?
No. CPT code 92953 refers to temporary transcutaneous pacing, whereas CPT code 33210 refers to the insertion or placement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure) and CPT code 33211 refers to the insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure).
Is ultrasound separately billable if used during temporary transvenous pacing for guidance or to confirm electrode placement in the appropriate ventricle?
No. Ultrasound guidance is not separately reportable for transvenous pacing CPT codes (you cannot report: 76937, 76942, 76998, 99318 or other US procedural codes if US is used during guidance for CPT codes: 33202-33275 or 93600-93662).
Is moderate (conscious) sedation separately billable if used during transcutaneous or transvenous pacing?
Yes. Report moderate (conscious sedation) when provided. The sedation may be performed by the physician performing the transvenous (or transcutaneous pacing) (99151-99153) or by another physician (99155-99157). Sedation and pacing are separate procedures and are indicative of a more complex service.
Can transvenous pacing be billed separately from critical care?
Yes, see ACEP Critical Care FAQ for further details. Time spent performing temporary transvenous pacing should not be included in the total critical care time reported.
What if my attempt at transvenous pacing is unsuccessful? Do I still get reimbursed for the attempt?
Reimbursement patterns vary depending on the payer. Additionally, some groups may choose not to code failed procedures for various reasons.
If a group decides to code and bill for a failed procedure, a modifier is typically applied. For example, if the procedure is partially reduced or not completed at the discretion of the physician or qualified health care professional, it may be reported with modifier 52 (“Reduced Services”). If the procedure is interrupted due to extenuating circumstances or a threat to the patient's well-being, it may be reported with modifier 53 (“Discontinued Procedure”), according to CPT guidelines.In both cases, your documentation should clearly state what portions of the procedure were completed and why the procedure was discontinued.
It’s important to note that both modifiers 52 and 53 usually result in reduced payment from payers.
Updated November 2025
Disclaimer
The American College of Emergency Physicians (ACEP) has developed the Reimbursement & Coding FAQs and Pearls for informational purposes only. It is recommended to consult related governing bodies for detailed and up-to-date information. The FAQs and Pearls have been developed by sources knowledgeable in their fields, reviewed by a committee, and are intended to describe current coding practice. However, ACEP cannot guarantee that the information contained in the FAQs and Pearls is in every respect accurate, complete, or up to date.
The FAQs and Pearls are provided "as is" without warranty of any kind, either express or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Payment policies can vary from payer to payer. ACEP, its committee members, authors, or editors assume no responsibility for, and expressly disclaim liability for, damages of any kind arising out of or relating to any use, non-use, interpretation of, or reliance on information contained or not contained in the FAQs and Pearls. In no event shall ACEP be liable for direct, indirect, special, incidental, or consequential damages arising from the use of such information or material. Specific coding or payment-related issues should be directed to the payer.
For information about this FAQ/Pearl, or to provide feedback, please contact ACEP's Reimbursement Team.
