CPT 33017 Pericardial Drainage Reimbursement | OpenPayer

Summary & Overview

CPT 33017: Percutaneous Pericardial Drainage with Indwelling Catheter

CPT code 33017 represents percutaneous pericardial drainage with insertion and retention of an indwelling catheter for continued drainage in patients aged 6 years and older without congenital cardiac anomaly. This procedure addresses pericardial effusion or tamponade and is performed under imaging guidance when indicated. Nationally, the code captures a critical, often urgent interventional service that interfaces with cardiology, interventional radiology, and thoracic surgery care pathways. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical scope, typical sites of service, and common procedural context. The publication outlines benchmarking considerations and payer coverage themes, clarifies included imaging guidance, and situates 33017 within related procedure groupings for coding and billing workflows. Data not available in the input are noted where applicable. This summary is intended to inform coding professionals, billing managers, and policy analysts about the clinical and billing significance of CPT code 33017 at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare33017CPTpericardial drainageinterventional cardiologyprocedure codingimaging guidancehospital outpatientinpatient procedure

Billing Code Overview

CPT code 33017 describes percutaneous pericardial drainage with catheter insertion for ongoing drainage in a patient aged 6 years or older without congenital cardiac anomaly. The procedure uses a needle inserted through the chest wall to access and evacuate fluid from the pericardial space and includes placement of an indwelling catheter for continued drainage. Fluoroscopy and/or ultrasound guidance, when performed, is included in this code.

Service type: Percutaneous pericardial drainage with indwelling catheter
Typical site of service: Hospital inpatient or hospital outpatient procedure area (interventional radiology or cardiothoracic procedure suite)

Clinical & Coding Specifications

Clinical Context

A 12-year-old patient presents to the emergency department with progressive shortness of breath, tachycardia, and muffled heart sounds. Imaging (chest x-ray and echocardiography) demonstrates a large pericardial effusion with early signs of cardiac tamponade. The cardiothoracic surgery team and interventional cardiology coordinate care. After informed consent and brief pre-procedure evaluation, the patient is taken to a procedure suite or operating room. Under monitored anesthesia care or general anesthesia, the provider performs a percutaneous pericardiocentesis using a needle inserted through the chest wall into the pericardial space. Fluid is aspirated for immediate hemodynamic improvement and diagnostic studies. A catheter is placed and left indwelling for continued drainage and repeat sampling as needed. Ultrasound and/or fluoroscopic guidance is used for needle and catheter placement. The catheter is secured and drainage is recorded; fluid is sent for cytology, Gram stain, culture, and biochemical analysis. The patient is observed in a monitored unit with serial exams and imaging until drainage decreases and hemodynamics stabilize, at which time the catheter is removed and the patient discharged or admitted for further management.

Coding Specifications

Modifier	Description	When to Use
`11`	Normally appointed duty surgeon	Use when the surgeon performing the procedure is the physician primarily responsible for the patient’s care.

CPT 33018: Percutaneous Pericardial Drainage with Indwelling Catheter

CPT-33030-PERICARDIAL-TISSUE-REMOVAL-WITHOUT-CPB

CPT 33030: Removal of Damaged Pericardial Tissue Without Cardiopulmonary Bypass

CPT-33031-PERICARDIECTOMY-CARDIOPULMONARY-BYPASS

CPT 33031: Pericardiectomy With Cardiopulmonary Bypass

CPT-33025-PERICARDIAL-WINDOW-PERICARDIOTOMY-DRAINAGE

CPT 33025: Pericardial Window (Pericardiotomy)

CPT-33016-PERICARDIOCENTESIS-PERCUTANEOUS-DRAINAGE

CPT 33016: Percutaneous Pericardiocentesis with Imaging Guidance

CPT-33020-PERICARDIAL-CLOT-FOREIGN-BODY-REMOVAL

CPT 33020: Removal of Clot or Foreign Body from Pericardial Space

CPT-33019-PERICARDIAL-DRAINAGE-WITH-INDWELLING-CATHETER

CPT 33019: Percutaneous Pericardial Drainage with Indwelling Catheter

CPT-33050-PERICARDIAL-TUMOR-CYST-EXCISION

CPT 33050: Pericardial Tumor or Cyst Excision

Taxonomy Code	Specialty	Notes
2080P0800X	Cardiovascular Surgery	Surgeons who may perform pericardial drainage, particularly for complex cases or when open approaches are required.
207RC0000X	Pediatric Cardiology	Pediatric cardiologists commonly perform pericardiocentesis in children and adolescents.
207L00000X	Interventional Cardiology	Interventional cardiologists perform image-guided percutaneous pericardiocentesis and catheter placement.
2086S0123X	Thoracic Surgery	Thoracic surgeons may be involved when surgical drainage or pericardial window is considered.
364S00000X	Critical Care Medicine	Intensivists may perform or assist with pericardial drainage in critically ill patients or coordinate post-procedure care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I31.3`	Cardiac tamponade	Direct indication for pericardiocentesis to relieve hemodynamic compromise.
`I31.9`	Disease of pericardium, unspecified	General pericardial disease with effusion that may require drainage.
`I30.9`	Acute pericarditis, unspecified	Pericardial inflammation leading to effusion and potential need for drainage.
`I32`	Pericarditis in diseases classified elsewhere	Pericardial effusion secondary to systemic disease; drainage may be diagnostic or therapeutic.
`R57.0`	Cardiogenic shock	Severe hemodynamic compromise where pericardial drainage may be emergently required if tamponade is the cause.
`B33.2`	Viral pericarditis	Infectious cause of effusion where fluid analysis guides therapy; pericardiocentesis may be performed.
`C79.51`	Secondary malignant neoplasm of heart	Malignant pericardial effusion requiring therapeutic and diagnostic drainage.
`T81.2`	Accidental puncture and laceration during a procedure, not elsewhere classified	Included as a potential complication code relevant to procedural risk documentation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33010`	Pericardiocentesis, without imaging guidance; needle or catheter	Alternative code when only pericardiocentesis without indwelling catheter or without imaging guidance is performed.
`33014`	Pericardiostomy; subxiphoid or transthoracic, open or percutaneous, with drainage tube placement	Surgical pericardial drainage (pericardial window) performed when more definitive drainage is required; may be performed if percutaneous attempt fails.
`76937`	Ultrasound guidance for percutaneous needle placement	Used when ultrasound guidance is performed and documented in addition to the primary procedure if payer requires separate reporting (often included for `33017`).
`77002`	Fluoroscopic guidance for needle placement (radiologic supervision and interpretation)	Used when fluoroscopic guidance and radiology supervision are billed separately; guidance is typically included in `33017` but may be reported separately per payer rules.
`36556`	Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older	May be performed concurrently if central venous access is required for medication or monitoring during the same encounter.
`51702`	Insertion of temporary indwelling catheter, bladder	Included as an example of simultaneous procedural needs for critically ill patients; billed separately if performed during the same session.

OpenPayer