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    v1.0.28
    OpenPayerBilling CodesSurgical Procedures on the PericardiumCPT cpt-33031-pericardiectomy-cardiopulmonary-bypass
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    CPT 33031: Pericardiectomy with Cardiopulmonary Bypass

    Medicare pays $2322 on average nationally for this procedure.

    CPT code 33031 describes surgical excision of the pericardium, partial or complete, performed with the patient supported on cardiopulmonary bypass; this is a cardiac surgical procedure typically classified as open cardiac surgery and provided in an inpatient hospital operating room or cardiac surgical suite where cardiopulmonary bypass is available.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old male with recurrent, symptomatic constrictive pericarditis presents with progressive dyspnea, peripheral edema, and exercise intolerance despite medical management. Preoperative evaluation includes transthoracic and transesophageal echocardiography demonstrating pericardial thickening and ventricular interaction, chest CT to assess pericardial calcification, cardiac catheterization to evaluate hemodynamics, and routine labs. The patient is scheduled for a pericardiectomy under general anesthesia with full cardiopulmonary bypass support. The operative team includes a cardiothoracic surgeon, perfusionist, anesthesiologist, and cardiology consultants. The procedure involves median sternotomy, careful dissection and excision of the pericardium (partial or total) to relieve constriction, placement on cardiopulmonary bypass for hemodynamic stability and myocardial protection when indicated, intraoperative transesophageal echocardiography for real-time assessment, and postoperative transfer to the cardiothoracic intensive care unit for hemodynamic monitoring and ventilator management. Postoperative care includes pain control, monitoring for bleeding, arrhythmia surveillance, fluid management, and follow-up echocardiography prior to discharge.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    33340Repair of cardiac septal defect with cardiopulmonary bypassPerformed in the same operative setting if an intracardiac defect requiring repair is identified during pericardiectomy.
    93312Transesophageal echocardiography, intraoperative, including probe placement, and interpretationCommonly used intraoperatively to assess cardiac function and guide completeness of pericardial resection.
    33999Unlisted procedure, cardiac surgeryUsed when an unusual or highly complex pericardial procedure has no specific CPT code.
    99135Moderate sedation services provided by the same physician performing a procedureData not available in the input.
    00530Anesthesia for heart procedures; open heartAnesthesia code applicable when general endotracheal anesthesia is provided for pericardiectomy on cardiopulmonary bypass.
    33210Insertion of temporary transvenous pacing electrode, intracardiacPerformed if intraoperative or postoperative pacing is required for bradyarrhythmia management.

    Related Modifiers

    13 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

    Showing 1–10 of 13

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    207LP2900XPain Medicine (Anesthesiology) PhysicianAn anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
    2080P0006XDevelopmental - Behavioral Pediatrics PhysicianA developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal…
    237600000XAudiologist-Hearing Aid FitterAn audiologist/hearing aid fitter is the professional who specializes in evaluating and treating people with hearing loss, conducts a wide variety of …
    2084P0804XChild & Adolescent Psychiatry PhysicianChild & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, beh…
    175T00000XPeer SpecialistIndividuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans A…

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    A52.3Neurosyphilis, unspecified
    B33.3Retrovirus infections, not elsewhere classified
    C38.0Malignant neoplasm of heart
    C38.2Malignant neoplasm of posterior mediastinum
    C38.8Malignant neoplasm of overlapping sites of heart, mediastinum and pleura
    D65Disseminated intravascular coagulation [defibrination syndrome]
    D68.4Acquired coagulation factor deficiency
    I09.81Rheumatic heart failure
    I21.9Acute myocardial infarction, unspecified
    I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris

    Showing 1–10 of 28

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    Related Codes

    CPT-33016-PERICARDIOCENTESIS-PERCUTANEOUS-DRAINAGE

    CPT 33016: Percutaneous Pericardial Drainage (Pericardiocentesis)

    CPT-33017-PERCUTANEOUS-PERICARDIAL-DRAINAGE-CATHETER

    CPT 33017: Percutaneous Pericardial Drainage with Indwelling Catheter

    CPT-33018-PERCUTANEOUS-PERICARDIAL-DRAINAGE-CATHETER-PLACEMENT-PEDIATRIC-CONGENITAL

    CPT 33018: Percutaneous Pericardial Drainage with Indwelling Catheter

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

    CPT 33019: Percutaneous Pericardial Catheter Drainage

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

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

    CPT-33025-PERICARDIAL-WINDOW-PERICARDIOTOMY-DRAINAGE

    CPT 33025: Pericardial Window to Drain Pericardial Fluid

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

    CPT 33030: Pericardial Debridement Without Cardiopulmonary Bypass

    CPT-33050-PERICARDIAL-TUMOR-CYST-EXCISION

    CPT 33050: Pericardial Tumor or Cyst Excision

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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