Summary & Overview
CPT 33361: Transcatheter Aortic Valve Replacement, Percutaneous Femoral Approach
CPT code 33361 denotes transcatheter aortic valve implantation/replacement (TAVI/TAVR) performed percutaneously via the femoral artery to deliver an aortic valve prosthesis through a catheter. This minimally invasive alternative to open surgical aortic valve replacement has become an important option for patients with symptomatic aortic stenosis across risk profiles, driving significant utilization and payer attention nationally.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for percutaneous femoral TAVR, a summary of the service setting and typical care pathway, and a synthesis of what payers commonly consider when covering this service. The publication outlines where benchmarking data and policy updates typically appear — including utilization patterns, site-of-service considerations, and common documentation elements — and highlights areas where coding specificity affects claims and reporting.
This overview is intended for health policy analysts, revenue cycle leaders, and clinicians who need a clear, national-level briefing on CPT code 33361, its clinical role, and the payer landscape. Data not available in the input is noted where applicable; the focus remains on clinical description, service setting, and the primary payers relevant to national coverage and billing practice.
Billing Code Overview
CPT code 33361 describes a transcatheter aortic valve implantation or replacement (TAVI/TAVR) procedure performed via a percutaneous femoral artery approach. The procedure uses a catheter to deliver and deploy an aortic valve prosthesis through the lumen of the catheter into the native aortic valve position.
Service Type: Transcatheter aortic valve replacement (TAVR/TAVI) — percutaneous femoral approach
Typical Site of Service: Hospital operating room or catheterization laboratory (percutaneous endovascular setting)
Clinical & Coding Specifications
Clinical Context
A typical patient is an 78-year-old with symptomatic severe aortic stenosis (progressive exertional dyspnea, angina, or syncope) evaluated by a multidisciplinary heart team and deemed high or prohibitive risk for surgical aortic valve replacement. The patient undergoes a transfemoral transcatheter aortic valve implantation (TAVI/TAVR) under monitored anesthesia care or general anesthesia in a cardiac catheterization laboratory or hybrid operating room. Pre-procedure workflow includes transthoracic and/or transesophageal echocardiography, cardiac catheterization or CT angiography for annular sizing and peripheral vessel assessment, informed consent, and pre-procedure anticoagulation/antiplatelet management. Intra-procedure steps include percutaneous femoral arterial access, placement of sheaths and delivery catheter, positioning and deployment of the transcatheter aortic valve prosthesis across the native aortic valve, hemodynamic assessment, and vascular closure. Post-procedure workflow includes monitoring in a post-anesthesia care unit or cardiac step-down/intensive care unit, transthoracic or transesophageal echocardiography to confirm valve function and paravalvular leak assessment, management of vascular access site, and discharge planning with antithrombotic therapy and follow-up echocardiography.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier specified | Rarely applied; reserved when no other modifier applies |