Summary & Overview

CPT 0345T: Percutaneous Transcatheter Mitral Valve Repair

CPT code 0345T represents a percutaneous, catheter-based repair of the mitral valve for conditions such as stenosis or regurgitation. This minimally invasive structural heart procedure is increasingly relevant as transcatheter valve therapies expand treatment options for patients who are high-risk for open surgical repair. Nationally, the code captures advanced cardiac interventions that shift care from traditional operating rooms to catheterization laboratories and hybrid suites, with implications for utilization, facility planning, and payer coverage policies.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for transcatheter mitral valve repair, typical sites of service, and commonly reported modifiers. The publication outlines benchmarking points for utilization and reimbursement where available, summarizes relevant policy and coverage considerations across major payers, and situates the code within broader trends in structural heart interventions.

The content is intended for clinicians, hospital administrators, and coding and reimbursement professionals seeking a national-level briefing on CPT code 0345T, its clinical role, and the payer landscape affecting access and billing for transcatheter mitral valve repair.

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Billing Code Overview

CPT code 0345T describes a percutaneous, catheter-based repair of the mitral valve to correct defects such as mitral stenosis or mitral regurgitation. The procedure involves insertion of a catheter through the skin and vasculature to access and repair abnormalities of the mitral valve without open-heart surgery.

Service type: Percutaneous transcatheter mitral valve repair
Typical site of service: Hospital cardiac catheterization laboratory or hybrid operating room

Clinical & Coding Specifications

Clinical Context

A 78-year-old patient with symptomatic mitral regurgitation presents with progressive exertional dyspnea, fatigue, and episodes of pulmonary edema. Echocardiography demonstrates severe mitral regurgitation due to leaflet prolapse and increased left atrial pressure; the patient is a high-risk candidate for open surgical mitral valve repair because of age, frailty, and multiple comorbidities (chronic obstructive pulmonary disease and chronic kidney disease). The interventional cardiology team evaluates the patient and obtains informed consent for a percutaneous transcatheter mitral valve repair. The typical workflow includes pre-procedure evaluation (history, transthoracic and transesophageal echocardiography, cardiac catheterization if indicated), procedural sedation or general anesthesia in a cardiac catheterization lab or hybrid operating room, transseptal puncture, deployment of the transcatheter repair device to approximate mitral leaflets and reduce regurgitation, intraprocedural transesophageal echocardiographic guidance, completion angiography/echo to confirm result, and post-procedure monitoring in a recovery area or cardiac intensive care unit with follow-up echocardiography prior to discharge.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When substantial additional work or time is required beyond the usual services for the procedure.
`23`	Unusual anesthesia	When general anesthesia is used for a procedure that is normally performed with local/regional anesthesia.
`50`	Bilateral procedure	When the procedure is performed bilaterally (rare for mitral valve repair).
`51`	Multiple procedures	When multiple distinct procedures are performed in the same session in addition to the primary procedure.
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the procedure is started but discontinued due to extenuating circumstances or patient safety.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct portions of the procedure.
`66`	Surgical team	When a surgical team approach is required and documented for complex procedures.
`78`	Unplanned return to OR following initial procedure	When the patient returns to the operating room for a related procedure during the postoperative period.
`80`	Assistant surgeon	When an assistant surgeon is documented and participates in the procedure.
`81`	Minimum assistant surgeon	When a minimal assistance role is documented and meets payer criteria.
`82`	Assistant surgeon (when qualified resident not available)	When an assistant surgeon is used because a qualified resident is not available.
`73`	Discontinued outpatient hospital/ambulatory surgery before anesthesia	When the procedure is canceled after patient preparation but before anesthesia in an outpatient setting.
`78`	Unplanned return to operating/procedure room	When an unplanned return to the procedural suite for related treatment is required (duplicate of above but retained when applicable).

Taxonomy Code	Specialty	Notes
207RG0400X	Interventional Cardiology	Physicians performing transcatheter mitral valve interventions.
207RG0300X	Cardiology	Cardiologists involved in diagnosis and periprocedural care.
2086S0123X	Cardiothoracic Surgery	Surgeons who may perform surgical alternatives or be part of a heart team.
207RH0000X	Structural Heart Disease Specialist	Providers focused on structural interventions including mitral valve repair.
363L00000X	Anesthesiology	Anesthesia providers managing sedation or general anesthesia during the procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I34.0`	Nonrheumatic mitral (valve) prolapse	Common structural cause of mitral regurgitation treated with transcatheter mitral repair.
`I34.1`	Nonrheumatic mitral (valve) insufficiency	Direct indication for mitral valve repair when regurgitation is symptomatic or causes ventricular dysfunction.
`I08.0`	Rheumatic mitral stenosis with mitral regurgitation	Rheumatic disease causing mixed mitral pathology that may prompt percutaneous interventions in selected patients.
`I05.0`	Rheumatic mitral stenosis	Stenotic mitral valve disease that can be addressed with percutaneous mitral interventions in select cases.
`I97.810`	Postprocedural mitral valve disorder	Used for complications or follow-up coding when procedural-related mitral valve issues occur.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93458`	Catheter exchange during cardiac catheterization, placement of catheter and intraprocedural imaging (including hemodynamic measurements)	May be performed for transseptal access, hemodynamic assessment, and catheter exchanges during transcatheter mitral valve repair.
`93312`	Echocardiography, transesophageal, real-time with image documentation; including M-mode recording, when performed (intraoperative or intra-procedural)	Provides intraprocedural guidance for device positioning and assessment of repair effectiveness.
`93452`	Left heart catheterization including injection(s) for left ventriculography, when performed	May be done pre-procedure or during the intervention to assess coronary anatomy or left ventricular function.
`33361`	Percutaneous transcatheter mitral valve replacement/repair, percutaneous, with prosthetic valve, when performed (note: example code for related structural procedures)	Related structural heart intervention codes used for alternative or adjunctive transcatheter mitral valve therapies.
`92980`	Transcatheter implantation of intracoronary stent(s), with coronary angioplasty when performed	Not directly related but commonly performed in the same catheterization lab for concomitant coronary interventions when indicated.