US · guidance
CMS Pub. 100-03, ch. 1, § 20.26
Partial Ventriculectomy
CIM 35-95
(Also Known as Ventricular Reduction, Ventricular Remodeling, or Heart Volume
Reduction Surgery)
Not Covered
Partial ventriculectomy, also known as ventricular reduction, ventricular remodeling, or
heart volume reduction surgery, was developed by a Brazilian surgeon and has been
performed only on a limited basis in the United States. This procedure is performed on
patients with enlarged hearts due to end-stage congestive heart failure. Partial
ventriculectomy involves reducing the size of an enlarged heart by excising a portion of
the left ventricular wall followed by repair of the defect. It is asserted that this procedure
makes the failing heart pump better by improving the efficiency of the remaining left
ventricle.
Since the mortality rate is high and there are no published scientific articles or clinical
studies regarding partial ventriculectomy, this procedure cannot be considered reasonable
and necessary within the meaning of §1862(a)(1) of the Act. Therefore, partial
ventriculectomy is not covered by Medicare.
History
(Rev. 1, 10-03-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
38694d2d8a1d3f1688b477cf7d842b41b26eef17026c451de6dac11ccc011050
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