Summary & Overview
CPT 00562: Anesthesia for Major Cardiac and Great Vessel Procedures
CPT code 00562 designates anesthesia services for major cardiac and great-vessel procedures (excluding standard coronary artery bypass grafting) performed on patients one year and older when cardiopulmonary bypass (pump oxygenator) is required. Nationally, this code captures high-acuity intraoperative anesthesia tied to complex cardiothoracic surgical care and intensive resource use, making it relevant for hospital billing, anesthesia group specialty contracting, and payer policy alignment.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of where CPT code 00562 is used clinically, how it maps to service lines and typical sites of care, and the payer landscape relevant to coverage and claim adjudication. The publication also outlines common modifiers associated with anesthesia reporting and highlights related clinical context such as use of cardiopulmonary bypass and re-operation timing.
This analysis is designed for national audiences including hospital billing leaders, anesthesia providers, and payers seeking to align coding, billing policies, and clinical documentation practices for high-acuity cardiac anesthesia services.
Billing Code Overview
CPT code 00562 describes anesthesia services provided for patients aged one year or older undergoing major cardiac procedures that involve the heart, the pericardium (sac around the heart), and the great vessels of the chest (for example, the aorta and major pulmonary vessels). The procedure is specified as other than a coronary bypass procedure, though it may occur as a re-operation within one month of an original bypass.
Service type: General/complex intraoperative anesthesia for major cardiothoracic surgery requiring cardiopulmonary bypass (pump oxygenator required).
Typical site of service: Inpatient operating room or cardiac surgery suite within a hospital setting, where cardiopulmonary bypass is available for use.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with an ascending aortic aneurysm is scheduled for open repair requiring cardiopulmonary bypass. Preoperative evaluation includes cardiac anesthesia consult, review of prior cardiac history (including a remote coronary artery bypass grafting), airway assessment, coagulation studies, and consent for general endotracheal anesthesia with central venous and arterial monitoring. On the day of surgery the anesthesia team induces general anesthesia, places invasive monitoring (arterial line, central venous catheter, transesophageal echocardiography as indicated), performs induction and hemodynamic management, initiates cardiopulmonary bypass (pump oxygenator) with anticoagulation by the perfusion team, and manages intraoperative ventilation, anticoagulation reversal, and postoperative transfer to the cardiac intensive care unit. The typical site of service is an inpatient operating room within a tertiary care hospital. The service is provided to patients age 1 year or older undergoing non-coronary cardiac or great vessel procedures that require a pump oxygenator.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia care is substantially greater or more complex than typical for the listed code. |
23 | Unusual anesthesia | Use when anesthesia is medically necessary for a procedure that normally does not require general anesthesia. |
50 | Bilateral procedure | Use when procedures are performed bilaterally and policy allows bilateral reporting for related surgical codes. |
52 | Reduced services | Use when the anesthesia service is partially reduced or significantly less than described for the code. |
53 | Discontinued procedure | Use when the anesthesia is discontinued due to extenuating circumstances prior to completion. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons; affects surgical, sometimes anesthesia, billing relationships. |
77 | Repeat procedure by another physician | Use when a procedure is repeated by a different physician during the global period. |
78 | Unplanned return to OR | Use when the patient returns to the operating room for a related procedure during the postoperative period. |
AA | Anesthesia by anesthesiologist | Use to designate the anesthesiologist personally performed the anesthesia service. |
AD | Medical supervision by anesthesiologist | Use when the anesthesiologist medically directs multiple simultaneous anesthesia procedures. |
AS | Monitored anesthesia care by anesthesiologist | Use when provider performed MAC rather than general anesthesia when applicable. |
QK | Medical direction of two to four anesthesia providers | Use when anesthesiologist medically directs multiple anesthesia providers under CMS rules. |
QS | Monitored anesthesia care service | Use to indicate MAC services when reporting MAC-specific billing requirements. |
QX | CRNA service with medical direction by a physician | Use when a certified registered nurse anesthetist provides anesthesia under physician direction. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Cardiac anesthesiologists commonly manage anesthesia for procedures requiring cardiopulmonary bypass. |
207LC0200X | Critical Care Medicine | Perioperative critical care physicians participate in management for high-risk cardiac surgical patients. |
207RA0000X | Surgery - Cardiovascular | Cardiothoracic surgeons perform the operative repair of the heart and great vessels. |
363L00000X | Perfusionist | Clinical perfusionists operate the pump oxygenator during cardiopulmonary bypass (listed as a non-physician taxonomy). |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I71.2 | Thoracic aortic aneurysm, without rupture | Thoracic aortic aneurysm repair often requires cardiopulmonary bypass and falls squarely within 00562 indications. |
I71.1 | Thoracic aortic aneurysm, ruptured | Emergent repair of a ruptured thoracic aneurysm may require pump oxygenator and complex anesthesia management. |
I74.3 | Embolism and thrombosis of arteries of the lower extremities | Vascular embolic disease can be related when procedures on great vessels require embolic protection or bypass support. |
I21.9 | Acute myocardial infarction, unspecified | Patients with recent MI undergoing complex aortic or great vessel surgery may require specialized intraoperative management. |
I35.0 | Nonrheumatic aortic (valve) stenosis | Aortic valve procedures performed with aortic root or ascending aorta work may use cardiopulmonary bypass and anesthesia per 00562. |
I35.1 | Nonrheumatic aortic (valve) insufficiency | Aortic valve regurgitation requiring repair or root replacement involves bypass and anesthesia complexity. |
Z95.2 | Presence of prosthetic heart valve | Prior valve prosthesis may necessitate reoperation and influence anesthesia planning for redo sternotomy and bypass. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
00512 | Anesthesia for procedures on the heart and pericardium; not requiring pump oxygenator (adult) | Performed for less complex cardiac cases without cardiopulmonary bypass; contrasts with 00562 which requires a pump oxygenator. |
00530 | Anesthesia for thoracotomy procedures involving lung and pleura | May be used for concurrent thoracic procedures or conversions involving the pleura or lung fields. |
00567 | Anesthesia for procedures involving the great vessels of the chest, with pump oxygenator — pediatric/infant | Pediatric counterpart when patient age and code definitions differ; relevant if age-based applicability changes. |
00561 | Anesthesia for procedures on the heart and pericardium requiring pump oxygenator that are coronary artery bypass grafting (CABG) | Used when the procedure is a CABG requiring bypass; 00562 is specifically for non-coronary procedures requiring pump oxygenator. |
00630 | Anesthesia for procedures involving the heart and pericardium; reoperation within 30 days | Used for reoperations when timing affects anesthesia complexity and reporting — related modifier/consideration in workflow. |