Summary & Overview
CPT 33315: Open Cardiac Removal of Foreign Body or Clot with CPB
CPT code 33315 represents an open cardiac surgical procedure to incise the heart and remove an intracardiac foreign body or clot while the patient is supported on cardiopulmonary bypass. This code captures a high-acuity, operative service performed in the inpatient operating room by a cardiothoracic surgical team and has implications for resource utilization, perioperative risk management, and hospital billing for complex cardiac surgery. Nationally, accurate use of this CPT code matters for procedure tracking, quality measurement, and alignment of reimbursement with clinical complexity.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks and contextual information on coding and billing for this type of cardiac surgical service, clinical context that clarifies when the procedure is indicated, and policy-relevant considerations that can affect acceptance and claims adjudication. The content summarizes typical site-of-service expectations, the nature of the operative service, and the kinds of procedural documentation and coding clarity that support correct claim submission. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 33315 describes a surgical procedure in which the provider performs an incision into the heart to locate and remove a foreign body or intracardiac clot. The procedure is performed with the patient supported on a cardiopulmonary bypass (CPB) machine to maintain circulatory and respiratory function during the operation.
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Service type: Open cardiac surgical procedure involving intracardiac exploration and foreign body or clot extraction
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Typical site of service: Inpatient operating room with cardiothoracic surgical team and cardiopulmonary bypass support
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with atrial fibrillation on anticoagulation presents with acute hemodynamic instability and transthoracic echocardiography showing a large, mobile left atrial thrombus with intermittent obstruction of the mitral valve. After stabilization and multidisciplinary review, the cardiothoracic surgery team recommends open cardiac exploration with removal of the intracardiac clot. The patient is taken to the operating room, placed on general endotracheal anesthesia, median sternotomy performed, and cardiopulmonary bypass established. The surgeon incises the appropriate cardiac chamber (left atrium) under cardioplegic arrest, extracts the thrombus, inspects cardiac structures for additional embolic material, repairs any atrial wall defect, weans the patient from bypass, and closes. Postoperatively the patient is transferred to the cardiovascular intensive care unit for hemodynamic monitoring, anticoagulation management, and surveillance for complications such as bleeding, arrhythmia, or recurrent thromboembolism. Typical documentation elements include indication, informed consent, preoperative imaging, cardiopulmonary bypass details, chamber entered, foreign body or clot description, estimated blood loss, specimens, and postoperative plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Use when two surgeons work together as primary surgeons for portions of the procedure. |