Summary & Overview
CPT 33320: Suture Repair of Cardiac Great Vessels Without CPB
CPT code 33320 represents surgical suture repair of the heart's great vessels — including the aorta, pulmonary arteries and veins, or the vena cava — performed without cardiopulmonary bypass. This code captures an important category of major cardiovascular surgical interventions that can be urgent or elective and that often occur at tertiary hospitals and specialized cardiac centers. Nationally, accurate coding for these procedures affects clinical registries, hospital quality measures, and payer reimbursement for high-acuity cardiovascular care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, expected sites of service, and which payers commonly adjudicate claims for such cardiac operations. The publication outlines benchmarks and coding guidance, highlights payer considerations and common modifiers used with high-acuity surgical claims, and summarizes policy or billing updates where available. Where input data was not provided, the report notes that information is not available. This national summary is intended for coding professionals, hospital billing staff, and policy analysts who need a clear, authoritative reference for CPT code 33320.
Billing Code Overview
CPT code 33320 describes surgical repair of the great vessels of the heart — the large vessels that bring blood to and from the heart, including the aorta, pulmonary arteries and veins, or the vena cava. The procedure involves direct suture repair of these major cardiac vessels and is performed without the use of a shunt or cardiopulmonary bypass (CPB).
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Service type: Surgical repair of cardiac great vessels (non-CPB vascular repair)
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Typical site of service: Hospital operating room or tertiary care surgical center specializing in cardiothoracic procedures
Clinical & Coding Specifications
Clinical Context
A 62-year-old male presents with an acute traumatic laceration to the ascending aorta following a high-speed motor vehicle collision. He is hemodynamically stable after resuscitation, and imaging (CT angiography) demonstrates a localized defect of the aortic wall without need for cardiopulmonary bypass. The cardiothoracic surgeon performs an open repair using sutures to close the defect of the great vessel on the beating heart without use of a shunt or cardiopulmonary bypass. The operative workflow includes preoperative anesthesia evaluation, central venous and arterial access, median sternotomy or thoracotomy based on location, exposure of the affected great vessel (for example, ascending aorta or superior vena cava), debridement of the injury margins, primary suture repair or patch augmentation, hemostasis confirmation, and layered closure. Intraoperative monitoring includes transesophageal echocardiography and arterial line hemodynamics. Postoperative care involves intensive monitoring in a cardiac surgical unit, serial hemoglobin checks, neurovascular assessment, and imaging as indicated prior to discharge. Billing reflects the primary great vessel repair performed without cardiopulmonary bypass and should be documented with operative notes describing vessel(s) repaired, absence of CPB, and technique used.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the repair required substantially greater work than typical (extensive dissection, prolonged time) and documentation supports increased work. |