Summary & Overview
CPT 33335: Aortic or Great Vessel Repair with Graft on Bypass
CPT code 33335 identifies open surgical repair of the aorta or another great vessel using a graft while the patient is supported on cardiopulmonary bypass. This is a high-acuity cardiac/thoracic procedure commonly performed for aneurysm repair, dissection, or major vessel injury and has significant implications for hospital resource use, perioperative risk, and case-mix for cardiac surgical services. Nationally, this code represents complex operative care requiring specialized teams, perfusion services, and inpatient postoperative monitoring.
Key payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis covers payer coverage patterns and coding guidance relevant to hospital inpatient cardiovascular surgery and reimbursable procedure reporting.
Readers will find a concise clinical and coding overview, benchmarks for utilization where available, common modifiers used with this service, and notes on typical sites of care. The publication also summarizes clinical context for the procedure, operational considerations tied to cardiopulmonary bypass, and policy or coding clarifications that affect billing and documentation. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 33335 describes repair of the aorta or another great vessel using a graft performed while the patient is on cardiopulmonary bypass. This procedure is a cardiac/thoracic surgical intervention addressing major vascular pathology of the aorta or its primary branches.
Service Type: Open surgical aortic or great vessel repair with graft placement on cardiopulmonary bypass
Typical Site of Service: Inpatient operating room or cardiovascular surgical suite with cardiopulmonary bypass capabilities
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of hypertension and coronary artery disease presents with an enlarging ascending aortic aneurysm measuring 6.1 cm on CT angiography and associated aortic valve insufficiency. The cardiothoracic surgery team evaluates the patient and schedules an open aortic graft repair with cardiopulmonary bypass due to the aneurysm involving the ascending aorta and root. Preoperative workflow includes cardiology clearance, crossmatch and blood product planning, informed consent detailing risks of cardiopulmonary bypass, and coordination with perfusion services. Intraoperative workflow involves median sternotomy, institution of cardiopulmonary bypass, aortic cross-clamping, resection of the diseased aortic segment, and placement of a synthetic graft with appropriate anastomoses. Postoperative care includes transfer to the cardiothoracic intensive care unit for hemodynamic monitoring, ventilator support as needed, anticoagulation management, and wound care. Follow-up includes surveillance imaging and cardiology/cardiothoracic clinic visits.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Standard reporting when no modifier applies |
11 | Primary procedure |