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    v1.0.28
    OpenPayerBilling CodesTransmyocardial Revascularization ProceduresCPT cpt-33141-laser-revascularization-during-open-cardiac-procedure
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    CPT 33141: Laser Revascularization During Open Cardiac Procedure

    Medicare pays $120 on average nationally for this procedure.

    CPT code 33141 describes laser revascularization of the heart performed to restore myocardial blood flow when done at the same encounter as another open cardiac procedure (for example, coronary artery bypass grafting); service type: intraoperative adjunctive laser revascularization; typical site of service: inpatient or hospital operating room during an open cardiac surgery encounter.

    For related coverage guidance, see recent payer policy updates: Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA), Cardiovascular Disease Risk Assessment, Biomarkers for Myocardial Infarction and Chronic Heart Failure.

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male with multivessel coronary artery disease and refractory angina is scheduled for coronary artery bypass grafting (CABG). Preoperative coronary angiography demonstrates diffuse atherosclerotic disease with a territory not amenable to standard bypass grafting due to small, chronically occluded distal vessels. During the same operative encounter as the open CABG, the cardiothoracic surgeon performs transmyocardial laser revascularization to create channels in ischemic myocardium and augment perfusion to areas that cannot be bypassed.

    The clinical workflow includes preoperative cardiology evaluation, informed consent documenting combined procedures, anesthesia induction and median sternotomy for CABG. After completion of graft anastomoses, the surgeon uses a laser revascularization device on targeted ischemic regions of the left ventricle. Intraoperative hemodynamic monitoring and postoperative ICU care follow standard cardiac surgery protocols, with documentation specifying that laser revascularization was performed in conjunction with the open cardiac procedure.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    33533Coronary artery bypass, by arterial graft(s); single arterial graftCommon component of multivessel CABG performed in the same operative session as laser revascularization
    33517Coronary artery bypass, vein and other grafts, single coronary venous graftVenous grafting codes for CABG procedures that may be performed during the same encounter
    33210Temporary transvenous cardiac pacing, insertionMay be used perioperatively for management of bradyarrhythmias during/after cardiac surgery
    93458Coronary angiography with right and left heart catheterization including ventriculography when performed; with percutaneous placement of coronary stent(s) (list separately in some workflows)Preoperative diagnostic catheterization that informs need for CABG and adjunctive laser revascularization
    33361Extracorporeal circulatory support, percutaneous (intraoperative or postoperative ECMO)Support modalities that may be used in complex cardiac surgical cases where adjunctive procedures are performed

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    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…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    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…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    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…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    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…
    261QP0904XFederal Public Health Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    2080T0004XPediatric Transplant Hepatology PhysicianA pediatrician with expertise in transplant hepatology encompasses the special knowledge and skill required of pediatric gastroenterologists to care f…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    2471Q0001XQuality Management Radiologic TechnologistA radiologic technologist who specializes in quality management.
    103TF0000XFamily PsychologistA psychologist whose specialty is founded on principles of systems theory with the interpersonal system of the family the focus of assessment, interve…

    Related ICD-10-CM Codes

    30 rows

    ICD-10-CM CodeDescription
    I21.09ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
    I21.3ST elevation (STEMI) myocardial infarction of unspecified site
    I21.4Non-ST elevation (NSTEMI) myocardial infarction
    I22.0Subsequent ST elevation (STEMI) myocardial infarction of anterior wall
    I22.1Subsequent ST elevation (STEMI) myocardial infarction of inferior wall
    I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris
    I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
    I25.118Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
    I25.2Old myocardial infarction
    I25.5Ischemic cardiomyopathy

    Showing 1–10 of 30

    Related Payer Policy Updates

    Specialty: Cardiology1 / 2

    6 rows

    PolicyPayerEffective Date
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Cardiovascular Disease Risk Assessmentblue cross blue shield - louisiana2026-09-15
    Cardiovascular Disease Risk AssessmentBlue Cross Blue Shield - New Mexico2026-09-04

    Related Codes

    CPT-33140-LASER-REVASCULARIZATION-THORACOTOMY

    CPT 33140: Laser Revascularization of Heart via Thoracotomy

    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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