CPT 33250 Cardiac Arrhythmia Ablation Reimbursement | OpenPayer

Summary & Overview

CPT 33250: Cardiac Arrhythmia Ablation Without Bypass

CPT code 33250 denotes a cardiac procedure that destroys a small area of heart tissue above the ventricles to treat an abnormal heart rhythm, performed without cardiopulmonary bypass. This code captures a common electrophysiology intervention used to manage supraventricular arrhythmias and other focal rhythm disturbances. Nationally, the code is relevant to hospitals, ambulatory surgical centers, and cardiac specialty practices that provide catheter-based ablation services.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication offers a concise overview of clinical context, coding specifics, and payer coverage patterns where available.

Readers will learn the clinical purpose of CPT code 33250, typical sites of service, and which major payers are commonly involved in coverage and reimbursement. The report also summarizes benchmarking and policy-relevant considerations tied to electrophysiology procedures, and identifies where input data is not available. Data not available in the input.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 33250cardiac ablationelectrophysiologyarrhythmia treatmenthospital outpatientambulatory surgical centercardiologyprocedure coding

Billing Code Overview

CPT code 33250 describes a cardiac procedure in which the provider destroys a small area of heart tissue located above the ventricles that is responsible for producing an abnormal heart rhythm. The procedure is performed without placing the patient on cardiopulmonary bypass.

Service type: Cardiac arrhythmia ablation procedure
Typical site of service: Electrophysiology laboratory or cardiac catheterization suite (hospital outpatient department or specialized ambulatory surgical center)

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with symptomatic supraventricular tachycardia presents to the electrophysiology lab for catheter ablation. The patient has episodes of palpitations, dizziness, and documented narrow-complex tachycardia on ECG and ambulatory monitor. After pre-procedure evaluation including review of anticoagulation, informed consent, and cessation or adjustment of antiarrhythmic medications per protocol, the patient is brought to the EP suite. Under conscious sedation or general anesthesia (but not cardiopulmonary bypass), vascular access is obtained, intracardiac mapping catheters are placed, and targeted radiofrequency or cryoenergy is delivered to the small region of atrial tissue above the ventricles responsible for the arrhythmia. Post-ablation testing confirms noninducibility of the clinical arrhythmia. The patient is observed in recovery, monitored for access-site complications and arrhythmia recurrence, and discharged same day or after an overnight observation depending on clinical status and institutional protocols.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal baseline service	Use when the service is the primary procedure performed without complication.
`22`	Increased procedural services

CPT 33264: Implantable Defibrillator Pulse Generator Removal and Replacement

CPT-33259-EXTENSIVE-ATRIAL-ABLATION-AND-RECONSTRUCTION

CPT 33259: Extensive Atrial Ablation and Reconstruction

CPT-33257-ATRIAL-ABLATION-AND-RECONSTRUCTION-ADD-ON

CPT 33257: Atrial Tissue Ablation and Atrial Reconstruction (Add-On)

CPT-33251-CARDIAC-ABLATION-WITH-CARDIOPULMONARY-BYPASS

CPT 33251: Surgical Cardiac Ablation With Cardiopulmonary Bypass

CPT-33267-LEFT-ATRIAL-APPENDAGE-EXCLUSION-OPEN-SURGERY

CPT 33267: Left Atrial Appendage Exclusion, Open Surgical Procedure

CPT-33254-ATRIAL-ABLATION-AND-ATRIAL-RECONSTRUCTION

CPT 33254: Atrial Ablation with Left and Right Atrial Reconstruction

CPT-33255-ATRIAL-ABLATION-AND-ATRIAL-RECONSTRUCTION-OFF-PUMP

CPT 33255: Atrial Ablation and Reconstruction, Off‑Pump

CPT-33261-CARDIAC-VENTRICULAR-ABLATION-CARDIOPULMONARY-BYPASS

CPT 33261: Surgical Ventricular Ablation with Cardiopulmonary Bypass

CPT-33268-LEFT-ATRIAL-APPENDAGE-EXCLUSION-OPEN-SURGERY

CPT 33268: Left Atrial Appendage Exclusion, Open Cardiac Surgery

CPT-33258-ATRIAL-FIBRILLATION-ATRIAL-RECONSTRUCTION-NO-BYPASS

CPT 33258: Surgical Atrial Ablation with Extensive Atrial Reconstruction

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Taxonomy Code	Specialty	Notes
207RH0000X	Cardiac Electrophysiology	Electrophysiologists perform catheter ablation for arrhythmias.
207RC0000X	Cardiovascular Disease	Interventional cardiologists with EP training may perform ablations in some centers.
208000000X	Internal Medicine	Hospitalists or internists manage pre- and post-procedure medical optimization and follow-up.
363A00000X	Registered Nurse Anesthetist	Provides sedation or anesthesia support in the EP lab when required.
333600000X	Physician Assistant	May assist with procedural support and follow-up under physician supervision.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I47.1`	Supraventricular tachycardia	Common indication for catheter ablation targeting atrial tissue above the ventricles.
`I48.0`	Paroxysmal atrial fibrillation	May require targeted ablation when originating from atrial foci above the ventricles.
`I48.1`	Persistent atrial fibrillation	Considered for ablation therapies when medically indicated and refractory to meds.
`I49.01`	Ventricular fibrillation	Not a direct target for this specific above-ventricular ablation code but relevant in broader arrhythmia management — included for context.
`I45.6`	Pre-excitation syndrome (e.g., Wolff-Parkinson-White)	Ablation of accessory pathways above the ventricles is a standard curative therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93613`	Mapping for arrhythmia; including electroanatomic mapping for catheter ablation	Performed before or during ablation to identify arrhythmogenic focus and guide therapy.
`93656`	Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple catheters, with induction or attempted induction of arrhythmia and ablation when performed	Often billed when a full diagnostic EP study with induction and ablation are performed in the same setting.
`33208`	Insertion, repositioning, removal of temporary transvenous lead, pacing or cardioversion	May be required peri-procedurally for pacing support or management of bradyarrhythmias during ablation.
`93797`	Physician or other qualified health care professional services for remote monitoring of cardiac device transmission	May be used in follow-up when patients have implanted devices that require monitoring after ablation.
`93010`	Electrocardiographic rhythm strip(s) tracing report, follow-up or routine monitoring	Used pre- and post-procedure for rhythm documentation and immediate clinical assessment.

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