Summary & Overview
CPT 33305: Cardiac Wound Repair on Cardiopulmonary Bypass
CPT code 33305 denotes surgical repair of a heart wound performed with the patient on cardiopulmonary bypass. This is a high-acuity, operative cardiac procedure typically performed in inpatient hospital operating rooms or specialized cardiac surgery suites. The code captures a critical, resource-intensive intervention that has implications for hospital billing, surgical staffing, and perioperative care coordination.
Key national payers commonly involved in coverage for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when this procedure is used, operational considerations tied to inpatient surgical settings, and the types of benchmarks and policy issues that influence coverage and payment for complex cardiac operations. The publication outlines typical service settings, common modifiers associated with surgical services when available, and notes where input data was not provided.
The analysis is intended for hospital administrators, coding and billing professionals, and policy analysts seeking a concise reference for CPT code 33305, its clinical role, and the payer landscape affecting reimbursement and utilization at a national level.
Billing Code Overview
CPT code 33305 describes a surgical procedure in which the provider repairs a wound to the heart while the patient is supported on a cardiopulmonary bypass (CPB) machine. The service type is operative cardiac surgery involving direct repair of cardiac trauma or defect under cardiopulmonary bypass. The typical site of service is an inpatient hospital operating room or cardiac surgery suite where cardiothoracic surgical teams and bypass equipment are available.
Clinical & Coding Specifications
Clinical Context
A 58-year-old male presents after sustaining a penetrating chest trauma from a motor vehicle collision with hemodynamic instability and signs of cardiac tamponade. In the emergency department the patient is intubated, resuscitated, and taken emergently to the operating room for median sternotomy. Upon exposure, a laceration to the right ventricle is identified with active bleeding and cardiac instability. The cardiothoracic surgical team places the patient on cardiopulmonary bypass (CPB) to provide hemodynamic and respiratory support, inspects the intracardiac injury, and performs primary repair of the cardiac wound. Intraoperative transesophageal echocardiography confirms adequate repair and no residual intracardiac shunt. The patient is weaned from CPB, chest is closed, and the patient is transferred to the cardiac intensive care unit for postoperative monitoring, vasoactive support as needed, and planned follow-up imaging and wound care.
Common clinical workflow steps:
-
Initial trauma evaluation, airway stabilization, and rapid assessment for cardiac tamponade.
-
Emergent transport to the OR with cardiothoracic surgery and perfusion team assembled.
-
Establishment of cardiopulmonary bypass, surgical repair of cardiac wound (
33305), intraoperative imaging, hemostasis, and closure. -
Postoperative ICU management with monitoring for bleeding, infection, myocardial dysfunction, and organ perfusion.
Coding Specifications
| Modifier |
|---|