Summary & Overview
CPT 32661: Endoscopic Excision of Pericardial Cyst/Tumor
CPT code 32661 represents an endoscopic pericardial surgical procedure used to visualize the pericardial sac and remove pericardial cysts, tumors, or masses. Nationally, this code captures minimally invasive cardiothoracic procedures aimed at diagnosing and treating pericardial lesions while reducing morbidity compared with open approaches. Use of this code is relevant to hospitals, surgical centers, and payers managing high-acuity cardiothoracic care.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when the procedure is used, the typical site of service, and common billing practices for thoracoscopic pericardial mass excision. The publication summarizes benchmarks for utilization, notes relevant billing considerations, and outlines areas where policy or coverage nuances commonly arise for minimally invasive pericardial surgery.
This summary is intended to orient clinicians, billers, and policy analysts to the clinical purpose of CPT code 32661, the settings in which it is commonly reported, and the payer landscape affecting reimbursement and authorization processes. Data not available in the input is indicated where applicable.
Billing Code Overview
CPT code 32661 describes an endoscopic procedure to visualize the pericardial sac and remove a pericardial cyst, tumor, or mass. This is a surgical service performed using thoracoscopic or endoscopic techniques to access the pericardial space, visualize the lesion, and achieve excision or resection.
-
Service type: Endoscopic pericardial surgical procedure
-
Typical site of service: Operating room or specialized surgical suite, often performed by cardiothoracic surgery teams under general anesthesia
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient presents with progressive dyspnea and intermittent chest pain. Imaging with transthoracic echocardiography and chest CT identifies a well-circumscribed fluid-filled mass adjacent to the right atrioventricular groove consistent with a pericardial cyst. Cardiac surgery and cardiothoracic oncology teams evaluate risks and recommend thoracoscopic excision. In the operating room under general anesthesia with single-lung ventilation, a cardiothoracic surgeon performs video-assisted thoracoscopic pericardioscopy to visualize the pericardial sac and resect the cystic lesion. Intraoperative steps include thoracoscopic port placement, endoscopic inspection of the pericardial space, identification of the cyst, careful dissection from adjacent cardiac structures, complete excision or partial excision with biopsy if adherent tissue is present, hemostasis, and placement of a chest drain as indicated. Postoperative care includes monitoring in a PACU or ICU setting for hemodynamic stability, chest tube management, pain control, and follow-up imaging to confirm resolution. Documentation includes operative report with CPT code 32661, laterality if applicable, anesthesia type, intraoperative findings, pathology results if tissue sent, and any complications or additional procedures performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |