Summary & Overview
CPT 33130: Pericardial Tumor Excision
CPT code 33130 represents the surgical excision of a tumor from the pericardium and captures a relatively uncommon but clinically significant cardiac-oncology procedure. Nationally, this code is relevant for hospitals and specialty surgical centers that manage pericardial masses, whether benign or malignant, and for payers that cover complex cardiothoracic operations. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context of CPT code 33130, the typical sites of service and procedural setting, and which national payers commonly adjudicate claims for this service. The publication provides benchmarks and payment context where available, highlights coding considerations tied to surgical service lines, and summarizes policy and coverage themes affecting reimbursement for high-acuity cardiothoracic procedures. Data not available in the input is noted where specific benchmark figures, diagnosis mappings, or related code crosswalks would normally appear.
Billing Code Overview
CPT code 33130 describes the surgical removal of a tumor from the pericardium, the membranous sac surrounding the heart. This procedure is a surgical excision of a pericardial tumor performed by cardiothoracic or cardiothoracic-oncology surgeons.
Service type: Surgical procedure — pericardial tumor excision
Typical site of service: Inpatient hospital or specialized surgical center (operating room)
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to cardiothoracic surgery after imaging identifies a symptomatic pericardial mass or pericardial tumor causing constriction, effusion with tamponade physiology, or chest pain and dyspnea. Preoperative workup includes transthoracic and/or transesophageal echocardiography, chest CT or cardiac MRI to define tumor size and location, cardiac catheterization if coronary anatomy is needed, and routine labs including coagulation. The procedure, coded as 33130, is performed in an operating room or cardiac surgery suite under general endotracheal anesthesia. Intraoperative monitoring includes arterial line, central venous access, transesophageal echocardiography, and cardiopulmonary bypass availability if resection is technically complex or tumor invades myocardium. The surgeon exposes the pericardium via median sternotomy or thoracotomy, performs pericardiectomy as needed, and excises the tumor with attention to hemostasis and preservation of cardiac structures. Resected tissue is sent for pathology. Postoperative care occurs in a cardiac recovery unit or intensive care unit with monitoring for tamponade, arrhythmia, bleeding, infection, and hemodynamic instability. Typical hospital stay ranges from 2–7 days depending on complexity and comorbidities. Billing reflects the operative removal of a pericardial tumor and may include concurrent services such as pericardial window or biopsy when reported appropriately with correct modifiers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard reporting | Use for routine reporting when no other modifier applies |
11 | Standard (Office determines) — typically not used for surgical CPTs but included in system lists | Rarely applied; not commonly appropriate for operative reports |
22 | Increased procedural services | Use when work required is substantially greater than typically required (extensive dissection, unexpected complexity) |
23 | Unusual anesthesia | Use when general anesthesia is not used due to circumstances and unusual anesthesia is required; infrequently applicable to most cardiac resections |
26 | Professional component | Use when only the physician interpretation or professional portion of a service is reported (e.g., pathology professional component) |
50 | Bilateral procedure | Use only if identical bilateral operative work is performed (rare for pericardial tumor removal) |
51 | Multiple procedures | Use when multiple distinct procedures are performed during the same operative session in addition to 33130 |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances prior to completion |
62 | Two surgeons | Use when two surgeons work together as primary surgeons throughout the procedure |
78 | Return to OR for related procedure during global period | Use when the patient returns to the operating room for a related procedure during the global period for 33130 |
79 | (Not in provided list) | Data not available in the input. |
80 | Assistant surgeon | Use when a surgical assistant performs part of the procedure (assistant at surgery) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2080S0003X | Cardiothoracic Surgery | Primary specialty performing pericardial tumor resections |
| 207L00000X | Thoracic Surgery | Performs thoracotomy approaches and tumor resections involving pericardium |
| 208000000X | General Surgery | May perform pericardial procedures in centers without dedicated cardiothoracic teams |
| 208D00000X | Cardiac Surgery (Cardiovascular) | Cardiac surgical subspecialists performing complex resections and reconstructions |
| 207P00000X | Pulmonary Disease (for diagnostic collaboration) | Involved when bronchoscopic or pulmonary evaluation is part of the workflow |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C38.1 | Malignant neoplasm of pericardium | Primary malignant pericardial tumors that indicate need for surgical resection when localized or symptomatic |
D15.1 | Benign neoplasm of heart and other parts of the circulatory system | Benign pericardial tumors such as lipoma or hemangioma that may require excision for symptoms or mass effect |
I31.3 | Pericardial effusion (noninflammatory) | Effusion secondary to a pericardial mass; may necessitate drainage and tumor removal if recurrent or causing tamponade |
I31.4 | Cardiac tamponade | Acute hemodynamic compromise from effusion related to tumor; often prompts urgent pericardial drainage and tumor management |
I31.9 | Disease of pericardium, unspecified | General pericardial disease including masses or thickening where tumor excision is part of definitive therapy |
R07.9 | Chest pain, unspecified | Symptom driven evaluation leading to imaging and discovery of pericardial tumor requiring resection |
C80.1 | Malignant (primary) neoplasm, unspecified — cardiac involvement | Used when pathology confirms malignant disease involving pericardium and primary site is unspecified |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
33210 | Repair of cardiac or pericardial fistula; direct closure | May be performed if tumor resection results in fistula formation requiring repair during the same operative session |
33010 | Pericardiocentesis, including imaging guidance, when performed as a separate procedure | Performed preoperatively or emergently for tamponade prior to definitive tumor resection |
33025 | Pericardial window, subxiphoid or other approach | May be performed if a pericardial window is required for drainage or biopsy in conjunction with or prior to tumor removal |
88304 | Surgical pathology, gross and microscopic examination | Used for pathology processing and interpretation of the resected pericardial tumor specimen |
33999 | Unlisted procedure, cardiac; if additional cardiac reconstruction is not described by existing codes | Applied when unusual reconstruction beyond standard resection is required and no specific code exists |