Summary & Overview

CPT 0483T: Transcatheter Mitral Valve Replacement or Implantation

CPT code 0483T designates a transcatheter mitral valve implantation or replacement—a minimally invasive structural heart intervention in which a prosthetic mitral valve is delivered by catheter through a small skin incision and advanced to the heart to treat mitral valve prolapse or malfunction. The code captures a complex, device-dependent procedure that has national implications for cardiovascular care delivery, hospital resource use, and device coverage policy given its role as an alternative to open surgical valve repair or replacement.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical service settings, payer coverage patterns and benchmarks, relevant coding and billing considerations, and recent policy developments that affect authorization, site-of-service decisions, and inpatient vs outpatient classification. The publication also highlights common modifiers and payment nuances associated with advanced cardiac procedures. Where specific data points are not provided in the input, the report notes that those items are not available.

This summary is intended for hospital administrators, clinical coders, reimbursement analysts, and policy stakeholders seeking a national-level briefing on how CPT code 0483T fits into contemporary structural heart care and payer policy.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0483TCPTtranscatheter mitral valvestructural heart interventioncardiac catheterizationmitral valve replacementminimally invasive cardiac procedurehospital billing

Billing Code Overview

CPT code 0483T describes a transcatheter mitral valve replacement or implantation procedure. The provider implants a prosthetic mitral valve, or replaces one, by inserting a catheter through a small skin incision and threading it through a vessel to the heart; the provider may or may not puncture the wall between the ventricle and atrium to place the valve. The service is a cardiac interventional procedure performed to treat mitral valve prolapse or malfunction.

Service Type: Transcatheter mitral valve implantation/replacement (structural heart intervention)

Typical Site of Service: Hospital-based cardiac catheterization lab or hybrid operating room; inpatient or selected outpatient settings, depending on patient acuity and institutional protocols.

Clinical & Coding Specifications

Clinical Context

A 78-year-old patient with symptomatic severe mitral regurgitation from degenerative mitral valve prolapse presents with progressive dyspnea on exertion, orthopnea, and reduced exercise tolerance despite optimized medical therapy. The heart team (interventional cardiology and cardiothoracic surgery) evaluates the patient and determines a transcatheter mitral valve replacement is appropriate due to elevated surgical risk. Pre-procedure workup includes transthoracic and transesophageal echocardiography to define valve anatomy, cardiac CT for annular sizing and vascular access planning, coronary angiography as indicated, and routine labs and coagulation studies. On the day of service, the patient is brought to a hybrid operating room or cardiac catheterization laboratory; vascular access (commonly femoral venous and arterial) is obtained, heparin anticoagulation is administered, and transseptal puncture is performed if required to access the mitral valve. Under fluoroscopic and echocardiographic guidance, the operator advances the delivery catheter to the mitral annulus and deploys the prosthetic mitral valve. Hemodynamic assessment and imaging confirm valve position and function; any residual paravalvular leak is assessed and addressed if needed. The patient is monitored in a post-anesthesia care unit or cardiac intensive care unit, with post-procedure echocardiography prior to discharge and instructions for antithrombotic therapy and follow-up with cardiology and heart valve clinic.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

Taxonomy Code	Specialty	Notes
`208K00000X`	Cardiothoracic Surgery	Surgeons who perform surgical mitral valve procedures and participate in hybrid valve interventions.
`207RH0000X`	Interventional Cardiology	Operators who perform transcatheter mitral valve replacement and related catheter-based interventions.
`207RI0200X`	General Cardiology	Cardiologists involved in pre-procedure evaluation, echocardiography, and post-procedure management.
`363L00000X`	Nurse Practitioner	Advanced practice clinicians who assist in perioperative management and procedure support.
`363A00000X`	Physician Assistant	Clinicians who assist in the intraoperative and postoperative care of valve replacement patients.

ICD-10 Code	Description	Clinical Relevance
`I34.0`	Nonrheumatic mitral (valve) insufficiency	Primary diagnosis for mitral regurgitation treated with transcatheter mitral valve replacement.
`I34.1`	Nonrheumatic mitral (valve) stenosis	Mitral stenosis can be an indication for valve replacement when symptomatic and severe.
`I34.9`	Disease of mitral valve, unspecified	Use when mitral valve disease is documented but not further specified; may support the procedure.
`I05.2`	Rheumatic mitral stenosis with insufficiency	Rheumatic mitral disease with mixed lesions that may require valve replacement in selected cases.
`I39`	Endocarditis and heart valve disorders in diseases classified elsewhere	Active or resolving infective processes affecting valves; timing of transcatheter implantation must be considered.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33361`	Percutaneous transcatheter mitral valve repair, with implantation of a prosthetic mitral valve (transcatheter mitral valve replacement), percutaneous approach	Alternative specific code for transcatheter mitral valve procedures when this code applies; used depending on payer coding guidance and exact technique.
`93458`	Catheter placement in coronary artery(s) for coronary angiography including intracoronary injection(s) for coronary angiography, when performed; with left heart catheterization including intraprocedural left ventriculography, when performed	Performed pre-procedure or intra-procedure to assess coronary anatomy or left ventricular function as part of the workup.
`93312`	Transesophageal echocardiography, real-time with image documentation, including probe placement, during diagnostic or interventional procedures	Used intra-procedurally for imaging guidance (transesophageal echocardiography) during transcatheter mitral valve implantation.
`93452`	Left heart catheterization including intraprocedural imaging when performed, during noncoronary procedures	May be used for hemodynamic assessment during valve implantation procedures.
`99223`	Initial hospital care, per day, for the evaluation and management of a patient, typically 70 minutes or more	Example of an initial hospital inpatient E/M service for medically complex patients undergoing valve implantation (use depends on payer rules and global period interactions).

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