Summary & Overview
CPT 33030: Removal of Damaged Pericardial Tissue Without Cardiopulmonary Bypass
CPT code 33030 represents surgical removal of damaged pericardial tissue performed without cardiopulmonary bypass. The code captures a targeted thoracic surgical procedure used to treat pericardial disease when removal of damaged tissue is indicated and cardiopulmonary bypass is not used. Nationally, accurate coding for this service affects procedural reporting, resource planning, and payment for cardiac surgical care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for 33030, typical settings of care, and the practical billing elements associated with reporting the procedure. The publication outlines common modifiers and documentation considerations, benchmarks for utilization and payment where available, and recent policy updates that influence coverage and coding practice. Clinical implications, such as indications for pericardial tissue removal and how the no-bypass approach differentiates this service from procedures that use cardiopulmonary bypass, are summarized to help billing and clinical staff align coding with operative reports.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes is noted where applicable. The content is intended for a national audience involved in medical billing, coding compliance, and cardiac surgical services.
Billing Code Overview
CPT code 33030 describes a surgical procedure in which the provider removes damaged pericardial tissue without cardiopulmonary bypass. The service is a thoracic surgical intervention focused on the pericardium and is performed via open or minimally invasive approaches as clinically indicated.
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Service type: Surgical procedure — pericardial tissue removal (pericardiectomy/pericardial debridement)
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Typical site of service: Inpatient or outpatient surgical setting, commonly performed in an operating room or cardiac surgery suite
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle-aged adult presenting with symptomatic constrictive or inflammatory pericardial disease, traumatic pericardial injury, or localized pericardial necrosis where damaged pericardial tissue requires surgical removal without use of cardiopulmonary bypass. The patient often has chest pain, dyspnea on exertion, signs of right-sided heart failure, or hemodynamic compromise from tamponade physiology. Preoperative evaluation includes history and physical, echocardiography (transthoracic and often transesophageal), chest CT or MRI to define pericardial thickness or effusion, routine labs, and anesthesia assessment.
The clinical workflow: the patient is admitted to a cardiothoracic surgery service or transferred from the emergency department. In the OR under general anesthesia and invasive monitoring, the surgeon performs a median sternotomy or subxiphoid approach, exposes the pericardium, and excises the damaged or diseased pericardial tissue. No cardiopulmonary bypass is initiated for 33030. Specimens may be sent for pathology and microbiology. Postoperative care includes ICU or step-down monitoring for hemodynamics, chest tube management if placed, pain control, and early mobilization. Discharge planning addresses follow-up with cardiothoracic surgery and cardiology, wound care, and guidance on activity restrictions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |