US · guidance
NCD 20.26
Partial Ventriculectomy
Item/Service Description
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.
Indications and Limitations of Coverage
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.
Revision History
03/1997 - Provided noncoverage policy. Effective date 04/15/1997. (TN 93)
History
Version 1
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-26
- Edition
- mcd-2026-08-26
- Content hash
b04930408c498f902ecf1fabaca5866d4598b3c566845852d2f4d49bbd48976e
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