C7539 HCPCS code: Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system)

C7539 is the HCPCS Level II code for insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system). In 2024 Medicare paid an average of $7,911.86 per service for C7539 across 160 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on outpatient hospital claims. Medicare volume rose 50% from 2023 to 2024 (107 to 160 services). In 2024, about 29 clinicians billed Medicare for C7539 for 160 beneficiaries.

Code details

FieldValue
SectionC codes — Outpatient PPS (hospital outpatient temporary codes)
Coverage codeD — Special coverage instructions apply
Pricing indicator11 — Priced using national relative value units (Physician Fee Schedule)
BETOS categoryP2E
Added2023-01-01
Last action effective2023-01-01

Who bills C7539 (2024)

MeasureValue
Clinicians billing (by place of service)29
Medicare beneficiaries160
States with claims3

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for C7539, 2023–2024

YearServicesBeneficiariesAvg. allowedAvg. paid
2023107107$9,783.80$7,795.22
2024160160$9,931.42$7,911.86

States with the most C7539 services (2024)

StateServicesAvg. paid
Illinois79$7,343.31
Texas18$8,243.68
California17$8,930.52

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
outpatient hospital claims1Anatomic Consideration
practitioner claims1Anatomic Consideration

Medicare policy articles for this code

Covered diagnoses (73 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

ICD-10-CMDiagnosisArticles listing it
G90.01Carotid sinus syncope1
I25.2Old myocardial infarction1
I25.5Ischemic cardiomyopathy1
I42.0Dilated cardiomyopathy1
I42.00Dilated cardiomyopathy, unspecified1
I42.01Familial-genetic dilated cardiomyopathy1
I42.09Other dilated cardiomyopathy1
I42.1Obstructive hypertrophic cardiomyopathy1
I42.2Other hypertrophic cardiomyopathy1
I42.6Alcoholic cardiomyopathy1

Showing 10 of 73. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for C7539

Frequently asked questions

What is HCPCS code C7539?

C7539 is the HCPCS Level II code for insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system). Short descriptor: "Insrt a & v pm w/l vent lead".

How much does Medicare pay for C7539?

In 2024, the average Medicare payment was $7,911.86 per service (average allowed $9,931.42).

Does Medicare cover C7539?

Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.

Which diagnoses support coverage for C7539?

Medicare policy articles that cite C7539 list 73 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include G90.01 (Carotid sinus syncope), I25.2 (Old myocardial infarction), I25.5 (Ischemic cardiomyopathy). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

How many units of C7539 can be billed per day?

1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).

Related C75 codes

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Next steps

Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.

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