CPT 32852 Single-Lung Transplant Reimbursement | OpenPayer

Summary & Overview

CPT 32852: Single-Lung Transplant with Cardiopulmonary Bypass

CPT code 32852 represents a single-lung transplant procedure performed with cardiopulmonary bypass. This high-acuity, resource-intensive surgical service is central to advanced thoracic surgical programs and transplant centers, with substantial implications for inpatient surgical capacity, critical care resources, and payer coverage policies nationwide. Key national payers commonly involved in covering this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical and operational context for this code, including typical site-of-service expectations, common modifiers used in billing, and the payer landscape relevant to reimbursement and authorization processes. The publication also summarizes benchmarks and policy topics that influence coverage and payment for lung transplantation, highlights coding considerations that affect claims processing, and outlines areas where payers and providers commonly focus prior authorization and medical necessity review. Data not available in the input is clearly noted where applicable, and the content is presented for a national audience rather than any specific jurisdiction.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 32852lung transplantthoracic surgerycardiopulmonary bypassinpatient surgerytransplant billingsurgical procedureshospital reimbursement

Billing Code Overview

CPT code 32852 describes a surgical procedure that includes cardiopulmonary bypass to replace a single lung with a healthy lung from a cadaveric or living donor. This procedure is a lung transplantation (single) performed with use of cardiopulmonary bypass.

Service type: Inpatient surgical transplant procedure
Typical site of service: Hospital inpatient operating room with postoperative inpatient care

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with end-stage pulmonary disease from chronic interstitial lung disease is evaluated for single-lung transplantation. After multidisciplinary review confirming candidacy, the patient undergoes preoperative testing including cardiopulmonary evaluation, infectious disease clearance, and transplant committee approval. On the day of surgery the patient is admitted to the operating room, intubated, and placed on cardiopulmonary bypass. The surgeon explants the diseased native lung and implants a size-matched donor lung from a cadaveric donor. Intraoperative steps include vascular anastomoses, bronchial anastomosis, hemostasis, chest tube placement, and transition off bypass. Postoperative care includes ICU monitoring, ventilator management, immunosuppression initiation, and surveillance for rejection and infection. Typical site of service is an inpatient hospital operating room with postoperative stay in the intensive care unit. Service type: major cardiac/thoracic transplant surgery with cardiopulmonary bypass.

Coding Specifications

Modifier	Description	When to Use
`00`	Distinct procedural service (not a CMS modifier; placeholder from input list)	Data not standard for CMS — not typically used; include only if payor requires a proprietary code.
`11`

CPT 32850: Lung Procurement and Cold Preservation

CPT-32851-SINGLE-LUNG-REPLACEMENT-WITHOUT-CARDIOPULMONARY-BYPASS

CPT 32851: Single Lung Replacement Without Cardiopulmonary Bypass

CPT-32853-BILATERAL-LUNG-TRANSPLANT-WITHOUT-BYPASS

CPT 32853: Bilateral Lung Transplant Without Cardiopulmonary Bypass

CPT-32854-BILATERAL-LUNG-TRANSPLANT-CARDIOPULMONARY-BYPASS

CPT 32854: Bilateral Lung Transplant with Cardiopulmonary Bypass

CPT-32856-DONOR-LUNG-PREPARATION-FOR-TRANSPLANT

CPT 32856: Donor Lung Preparation for Transplant

CPT-32855-SINGLE-DONOR-LUNG-PREPARATION-FOR-TRANSPLANT

CPT 32855: Preparation of Single Donor Lung for Transplant

Taxonomy Code	Specialty	Notes
208100000X	Cardiothoracic Surgery	Primary specialty performing lung transplantation and cardiopulmonary bypass procedures.
207R00000X	Pulmonary Disease	Pulmonologists manage pre- and post-transplant care, selection, and follow-up.
2084P0800X	Transplant Surgery	Surgeons specialized in organ transplantation involved in operative planning and anastomosis.
207L00000X	Critical Care Medicine	Intensivists manage immediate postoperative ICU care and ventilatory support.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J84.10`	Pulmonary fibrosis, unspecified	Common indication for lung transplantation when progressive fibrotic lung disease leads to respiratory failure.
`J44.9`	Chronic obstructive pulmonary disease, unspecified	COPD with end-stage disease can be an indication for single-lung transplant.
`J98.4`	Bronchiectasis, unspecified	Severe bronchiectasis refractory to medical therapy may lead to transplantation.
`D86.0`	Sarcoidosis of lung	Pulmonary sarcoidosis with advanced fibrotic changes can necessitate lung transplantation.
`I50.9`	Heart failure, unspecified	Coexisting cardiac dysfunction may complicate transplant candidacy and intraoperative management; cardiopulmonary bypass may be required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32852`	Thoracic organ transplantation including cardiopulmonary bypass for single-lung replacement	Primary procedure code for single-lung transplant with use of cardiopulmonary bypass.
`33945`	Cardiotomy, insertion of cannulae for cardiopulmonary bypass (separate code for bypass cannulation)	Performed at the start of the operation to establish cardiopulmonary bypass support for the transplant.
`32663`	Thoracotomy with lobectomy, single lobe (example intrathoracic procedure)	Related thoracic access procedures or resections that may be performed in conjunction with transplant when native lung resection is required.
`32853`	Bilateral sequential lung transplantation (if performed)	Related when bilateral transplant is performed instead of single-lung transplant; differentiates scope of surgery.
`32551`	Tube thoracostomy, including water seal (eg, chest tube placement)	Commonly performed intraoperatively or postoperatively for chest tube drainage after lung transplant.

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