Summary & Overview
CPT 33330: Graft Insertion into Heart Great Vessels Without CPB
CPT code 33330 represents a high-acuity cardiac surgical service: insertion of a graft into the heart’s great vessels (aorta, pulmonary arteries/veins, or vena cava) performed without cardiopulmonary bypass. Nationally, this code captures complex vascular reconstruction procedures that are central to tertiary cardiac surgery programs and have implications for inpatient surgical throughput, resource utilization, and reimbursement for cardiothoracic services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, common billing modifiers associated with cardiovascular surgery, and the payer mix reflected across major national insurers. The publication outlines standard coding use, claims considerations relevant to non-bypass grafting of great vessels, and where to expect policy variation across commercial and public payers.
This material is intended to inform coding professionals, revenue cycle staff, and policy analysts about the clinical scope and billing context for CPT code 33330, as well as to summarize what operational and coverage topics to review when preparing or adjudicating related claims. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 33330 describes a surgical procedure in which a graft is inserted into the great vessels of the heart — including the aorta, pulmonary arteries and veins, or the vena cava — without use of a shunt or cardiopulmonary bypass (CPB). This procedure involves direct replacement or augmentation of large central vessels to restore or preserve vascular integrity and cardiac outflow or inflow.
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Service type: Major cardiovascular surgical grafting procedure on great vessels
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Typical site of service: Inpatient operating room or cardiac surgical suite
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with symptomatic thoracic aortic aneurysm and severe aortic insufficiency is scheduled for open aortic graft insertion without use of cardiopulmonary bypass. The patient undergoes preoperative evaluation in the cardiothoracic clinic, including CT angiography to define graft sizing and coronary artery assessment. On the day of service the patient is admitted to the operating room, general anesthesia is induced, and a median sternotomy or thoracotomy is performed based on aneurysm location. The surgeon isolates the affected segment of the great vessel (commonly the ascending aorta or proximal arch), excises the diseased tissue as indicated, and inserts a prosthetic vascular graft to re-establish vessel continuity. No shunt or cardiopulmonary bypass is used per the procedure definition. Hemostasis is secured, chest closure performed, and the patient is transferred to the cardiothoracic recovery unit for monitoring. Typical perioperative documentation includes indication, informed consent, intraoperative findings, graft type/size, estimated blood loss, and any intraoperative complications. This procedure is typically performed in an inpatient hospital operating room or specialized ambulatory surgical center capable of cardiothoracic surgery and postoperative critical care.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or routine service | Use when the procedure is the usual scheduled service performed without unusual circumstances |