CPT 33120 Cardiac Tumor Excision Reimbursement

CPT code 33120 represents open surgical removal of a heart tumor performed with the patient on cardiopulmonary bypass. This high-complexity cardiac surgical procedure is performed by cardiothoracic surgeons in hospital operating rooms, often requiring intensive perioperative resources and coordination. Nationally, procedures like this are clinically significant due to their resource intensity, potential for major complications, and implications for facility and surgeon billing.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of clinical context and billing relevance, including typical sites of service, common payer coverage considerations, and how this code fits within cardiac surgical service lines. The publication outlines benchmarks where available, highlights relevant policy and coding guidance affecting reimbursement and documentation, and summarizes typical clinical scenarios associated with use of the code. Where input data is incomplete, the report notes missing elements as "Data not available in the input." The content is intended to give clinicians, billing professionals, and policy analysts a clear, national-level summary of CPT code 33120 and its role in coding and billing for cardiac tumor excision procedures.

Billing Code Overview

CPT code 33120 describes a surgical procedure in which the provider removes a tumor from the heart while the patient is placed on cardiopulmonary bypass. This procedure is a form of cardiac tumor excision performed in an operating room setting and typically requires cardiothoracic surgical expertise, anesthesia, and use of cardiopulmonary bypass equipment.

Service type: Surgical — open cardiac surgery for tumor removal
Typical site of service: Inpatient or ambulatory hospital operating room (cardiac surgery suite)

Data not available in the input.

Clinical Context

A 56-year-old patient presents with progressive exertional dyspnea and intermittent embolic phenomena. Transthoracic and transesophageal echocardiography identify a pedunculated left atrial mass consistent with a myxoma causing intermittent obstruction of the mitral valve or evidence of tumor fragments. Cardiac magnetic resonance imaging confirms a discrete intracavitary lesion without diffuse myocardial infiltration. The cardiac surgery team schedules open tumor excision with the patient placed on cardiopulmonary bypass to provide a motionless, bloodless field for precise resection. Preoperative workflow includes cardiology and anesthesia evaluation, informed consent discussing risks of bypass and potential need for valve repair or replacement, perioperative antibiotics, crossmatch for blood products, and coordination with perfusion services. Intraoperatively, median sternotomy is performed, the patient is cannulated for cardiopulmonary bypass, the heart is arrested, the surgeon excises the tumor with an adequate margin, inspects valves and chambers for residual tumor, and sends specimens for pathology. Postoperative care includes intensive care unit monitoring, hemodynamic support, anticoagulation management as indicated, and follow-up echocardiography to confirm complete resection and cardiac function recovery.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — standard reporting	Use when no additional modifier applies and the service is billed as primary.

Taxonomy Code	Specialty	Notes
`Cardiothoracic Surgery`	Cardiothoracic Surgeon	Primary specialty performing intracardiac tumor excision with cardiopulmonary bypass.
`Cardiovascular Surgery`	Cardiovascular Surgeon	Alternative specialty designation for surgeons performing open-heart procedures.
`Anesthesiology`	Cardiac Anesthesiologist	Provides perioperative anesthesia and transesophageal echocardiography monitoring.
`Perfusion`	Cardiopulmonary Perfusionist	Operates the cardiopulmonary bypass circuit; credentialed allied health specialty.
`Pathology`	Surgical Pathologist	Provides histopathologic diagnosis of excised tumor specimens.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D15.1`	Benign neoplasm of heart	Primary benign cardiac tumors such as myxoma are a common indication for intracardiac tumor excision.
`C38.0`	Malignant neoplasm of heart	Primary malignant cardiac tumors may require resection with cardiopulmonary bypass when feasible.
`I34.0`	Nonrheumatic mitral (valve) insufficiency	Tumor causing valvular dysfunction may necessitate concurrent valve assessment and possible repair during excision.
`I31.9`	Disease of pericardium, unspecified	Tumors involving pericardium or causing pericardial effusion may be managed surgically.
`I97.1`	Postprocedural cardiac complications, not elsewhere classified	Codes for complications encountered perioperatively; relevant for postoperative coding and monitoring.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`00562`	Anesthesia for procedures on heart and pericardial sac; not otherwise specified	Anesthesia services specific to major cardiac operations performed concomitantly with tumor excision.
`00567`	Anesthesia for procedures involving cardiopulmonary bypass	Use to report anesthesia complexity when bypass is used during the procedure.
`33216`	Removal of pacemaker or defibrillator lead (open) — example code (note: device-specific)	May be used if device extraction is required during tumor resection or to access intracardiac structures.
`33426`	Repair of atrial septal defect, with cardiopulmonary bypass	Related when septal repair is required after tumor excision involving the atrial septum.
`93503`	Insertion and placement of intracardiac catheter, diagnostic (e.g., intraoperative transesophageal echo probe billing may vary)	Intraoperative transesophageal echocardiography used to localize tumor and confirm resection; coding may be facility/payer dependent.

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Summary & Overview

CPT 33120: Cardiac Tumor Excision with Cardiopulmonary Bypass