Summary & Overview
CPT 33410: Aortic Valve Replacement with Stentless Tissue Valve
CPT code 33410 is a critical billing code for the surgical replacement of the aortic valve with a stentless tissue valve, performed under cardiopulmonary bypass. This advanced cardiothoracic procedure is most often carried out in inpatient hospital settings and is essential for patients with severe aortic valve disease. The code is recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, ensuring broad coverage and reimbursement across the United States.
This publication provides a comprehensive overview of 33410, including payer coverage, clinical context, and related coding benchmarks. Readers will gain insight into the procedural specifics, typical sites of service, and how this code fits within the broader landscape of cardiac surgery billing. Policy updates, clinical indications, and comparisons to related CPT codes are also discussed, offering a clear understanding of the code’s role in hospital reimbursement and patient care. The analysis is designed for healthcare professionals, administrators, and policy stakeholders seeking up-to-date information on aortic valve replacement coding and coverage.
CPT Code Overview
CPT code 33410 describes the replacement of the aortic valve using a stentless tissue valve, performed with cardiopulmonary bypass. This procedure is a form of cardiothoracic surgery and is typically conducted in an inpatient hospital setting (Place of Service 21). The use of a stentless tissue valve is significant for patients requiring aortic valve replacement, offering potential benefits in terms of valve function and durability. This code is central to hospital billing and clinical documentation for advanced cardiac surgical interventions.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient admitted to an inpatient hospital setting with severe aortic valve disease, such as aortic stenosis or insufficiency, requiring surgical intervention. The patient is evaluated by a cardiothoracic surgeon and determined to be a candidate for aortic valve replacement. During the procedure, the surgeon performs replacement of the aortic valve using a stentless tissue valve, with the support of cardiopulmonary bypass. The clinical workflow includes preoperative assessment, intraoperative management with bypass, and postoperative care in a cardiac unit. This procedure is most often performed by specialists in thoracic surgery, cardiovascular disease, or general surgery.
Coding Specifications
-
Modifier
22: Increased Procedural Services. Used when the procedure requires significant additional work beyond the typical service, such as complex anatomy or unexpected complications. -
Modifier
63: Procedure performed on infants less than 4 kg. Applied when the patient is an infant weighing less than 4 kilograms, indicating increased complexity and risk.
| Provider Taxonomy Code | Specialty Name |
|---|---|
208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
207RC0000X | Cardiovascular Disease Physician |
208600000X | Surgery Physician |
Related Diagnoses
-
I34.0: Nonrheumatic mitral (valve) insufficiency- Indicates mitral valve dysfunction, which may coexist with aortic valve disease and prompt surgical evaluation.
-
I34.1: Nonrheumatic mitral (valve) prolapse- Represents structural mitral valve abnormality, often assessed during preoperative workup for aortic valve replacement.
-
I34.2: Nonrheumatic mitral (valve) stenosis- Refers to narrowing of the mitral valve, which may be present alongside aortic valve pathology.
-
I05.0: Rheumatic mitral stenosis- Indicates mitral valve narrowing due to rheumatic disease, relevant in patients with multi-valvular involvement.
-
I05.1: Rheumatic mitral insufficiency- Represents mitral valve leakage from rheumatic origin, which may influence surgical planning for aortic valve replacement.
Related CPT Codes
-
33405: Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograft.- This code describes a similar procedure to
33410, but uses a prosthetic valve rather than a stentless tissue valve. It is an alternative option depending on valve selection.
- This code describes a similar procedure to
-
33406: Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograft.- This code is also related to
33410and may be used in cases where a different type of prosthetic valve is chosen. Both33405and33406are alternatives to33410based on clinical indications and valve type.
- This code is also related to
These codes are not typically used together in the same encounter, but are selected based on the specific valve replacement performed.
National Reimbursement Benchmarks
For CPT code 33410, the national mean rate for Medicare is $2,394.03, while the BUCA (average commercial) mean rate is $3,322.60. This indicates that commercial payers, on average, reimburse at a higher level than Medicare for this procedure.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare shows the tightest range at $190.00, reflecting relatively consistent rates. In contrast, UnitedHealth Group has the widest dispersion at $2,712.50, suggesting greater variability in contracted rates. Blue Cross Blue Shield and Cigna also exhibit substantial ranges, at $1,670.17 and $2,329.50 respectively.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.