Summary & Overview
CPT 33300: Repair of Wound to Heart Without Cardiopulmonary Bypass
CPT code 33300 designates surgical repair of a wound to the heart performed without cardiopulmonary bypass. This procedure is used to control bleeding or close myocardial lacerations when CPB is not required or feasible. Nationally, the code captures an acute cardiac operative service with implications for inpatient surgical workflows, coding specificity, and emergent cardiac care capacity.
Key payers covered in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. These payers commonly influence coverage policies, prior authorization pathways, and payment determinations for high-acuity cardiac procedures.
Readers will find concise clinical context for when the code is used, typical sites of service, and the service type. The publication also outlines the scope of benchmarking and policy elements typically associated with cardiac operative codes: payer coverage considerations, documentation and coding precision required for emergent cardiac repairs, and how this code fits in with related cardiac surgery procedure coding. Data not available in the input is indicated where applicable.
Billing Code Overview
CPT code 33300 describes a surgical procedure to repair a wound of the heart without use of cardiopulmonary bypass (CPB). The service is a cardiac surgical repair performed on the heart's surface or chambers to control bleeding or close traumatic or iatrogenic myocardial lacerations while the patient remains off the CPB machine.
Service type: Operative cardiac surgery (emergent or urgent cardiac repair)
Typical site of service: Inpatient operating room or cardiac surgery suite, often under general anesthesia in a hospital setting
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting emergently after penetrating or blunt chest trauma with a visible cardiac wound and hemodynamic instability. The patient is stabilized in the emergency department with intravenous access, blood products as needed, and rapid transport to the operating room. Cardiac surgery and trauma teams perform median sternotomy or limited thoracotomy under general anesthesia. The surgeon identifies a laceration to the myocardium or epicardium and performs direct repair using pledgeted sutures, topical hemostatic agents, and temporary measures as needed without instituting cardiopulmonary bypass. Intraoperative transesophageal echocardiography may be used to assess cardiac function and rule out additional injuries. Postoperative care includes monitoring in a cardiac intensive care unit, serial hemodynamic assessments, chest tube management, and surveillance for arrhythmia, tamponade, or bleeding. This procedure is commonly billed when repair is accomplished on the beating heart without use of a CPB machine.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normally expected performance of the service by the physician | Use when the surgeon is the primary operating practitioner and the procedure was performed as planned. |
22 |