TAVR/TAVI CPT 33362 Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 33362: Transcatheter Aortic Valve Replacement via Open Femoral Artery

CPT code 33362 represents transcatheter aortic valve implantation (TAVI/TAVR) in which an aortic valve prosthesis is inserted through the lumen of a catheter using an open femoral artery approach. This procedural code captures catheter-based aortic valve replacement when direct femoral arterial exposure is used, an important distinction for coding, billing, and clinical documentation across hospitals and cardiac centers. Nationally, TAVR procedures are a major component of structural heart interventions and carry implications for payment, resource allocation, and perioperative care pathways.

Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service represented by the code, typical site-of-service considerations, and the payer landscape relevant to this procedure. The publication outlines benchmarks, common billing modifiers (where data is available), and contextual clinical notes that clarify when this code applies versus other transcatheter aortic valve codes. It also highlights policy and billing considerations that affect reimbursement and documentation requirements for hospitals and cardiac service lines.

The report is designed for coding professionals, hospital revenue leaders, and clinicians involved in structural heart programs who need a clear reference for CPT code 33362, its clinical context, and how it aligns with national payer coverage patterns and administrative practices.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare33362CPTTAVRTAVItranscatheter aortic valve replacementstructural heartcardiac surgeryfemoral artery approach

Billing Code Overview

CPT code 33362 describes transcatheter aortic valve replacement (TAVR/TAVI) performed by inserting an aortic valve prosthesis through the lumen of a catheter using an open femoral artery approach. The service is a catheter-based aortic valve replacement delivered via the femoral artery with direct arterial exposure.

Service Type: Transcatheter aortic valve replacement (TAVR/TAVI) via open femoral artery approach

Typical Site of Service: Hospital operating room or hybrid cardiac catheterization suite

Clinical & Coding Specifications

Clinical Context

An 82-year-old male with symptomatic, severe aortic stenosis (progressive dyspnea on exertion, New York Heart Association Class III symptoms) and multiple comorbidities that increase surgical risk is evaluated for transcatheter aortic valve implantation using an open femoral artery approach (TAVR/TAVI, CPT 33362). Pre-procedure workup includes transthoracic and transesophageal echocardiography to confirm valve anatomy and severity, gated CT angiography of the aorta and iliofemoral vessels to assess vessel size and calcification, and a multidisciplinary heart team review (interventional cardiology, cardiothoracic surgery, cardiac anesthesia). The patient is admitted on the day of procedure to an operating room or hybrid catheterization suite; general anesthesia or monitored anesthesia care is provided. An open surgical exposure of the common femoral artery is performed, a sheath is placed, and a transcatheter aortic valve prosthesis is advanced and deployed across the native aortic valve under fluoroscopic and echocardiographic guidance. Post-deployment assessment includes angiography and echocardiography to confirm valve position and function. Hemostasis is achieved at the surgical femoral arteriotomy prior to transfer to a post-anesthesia care unit and then a monitored inpatient setting for 24–72 hour observation.

Service Type: Invasive cardiac valve replacement (transcatheter aortic valve implantation) via open femoral artery access.
Typical Site of Service: Operating room or hybrid catheterization laboratory with surgical capability and postoperative inpatient monitoring.

Coding Specifications

CPT 33367: Cardiopulmonary Bypass During Primary TAVI/TAVR

CPT-33412-AORTIC-VALVE-REPLACEMENT-ANNULAR-ENLARGEMENT-KONNO

CPT 33412: Aortic Valve Replacement with Annular Enlargement or Konno Procedure

CPT-33365-TRANSAORTIC-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-TAVR

CPT 33365: Transaortic Transcatheter Aortic Valve Replacement (TAVR)

CPT-33361-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-FEMORAL

CPT 33361: Transcatheter Aortic Valve Replacement, Percutaneous Femoral Approach

CPT-33364-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-ILIAC-ARTERY-APPROACH

CPT 33364: Transcatheter Aortic Valve Replacement via Open Iliac Artery Approach

CPT-33370-CEREBRAL-EMBOLIC-PROTECTION-TAVR

CPT 33370: Cerebral Embolic Protection During TAVR

CPT-33414-LEFT-VENTRICULAR-OUTFLOW-TRACT-PATCH-ENLARGEMENT

CPT 33414: Left Ventricular Outflow Tract Patch Enlargement

CPT-33416-VENTRICULOMYOTOMY-VENTRICULOMYECTOMY-SEPTAL-MYECTOMY

CPT 33416: Ventriculomyotomy/Ventriculomyectomy for Subaortic Stenosis

CPT-33415-SUBVALVULAR-AORTIC-STENOSIS-SURGICAL-RESECTION

CPT 33415: Subvalvular Aortic Stenosis Resection

CPT-33410-STENTLESS-AORTIC-VALVE-REPLACEMENT

CPT 33410: Aortic Valve Replacement with Stentless Prosthetic Valve

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Modifier	Description	When to Use
`00`	No modifier (standard reporting)	Use when no additional modifier applies and procedure is reported normally.
`11`	Principal physician of record	Use when the reporting physician is the primary responsible physician.
`22`	Unusual procedural services	Use when the procedure requires significantly greater work than typical (document rationale).
`23`	Unusual anesthesia	Use when general anesthesia is indicated for a procedure normally performed with local anesthesia.
`50`	Bilateral procedure	Not typically applicable to `CPT 33362` (listed if bilateral access or simultaneous bilateral procedures are performed, document accordingly).
`52`	Reduced services	Use when a portion of the planned service is not completed but some work was performed.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons during portions of the procedure.
`63`	Procedure performed on infants less than 4 kg	Rarely applicable; include only if patient meets weight criteria.
`66`	Surgical team (complex)	Use when a surgical team approach is required, with documented need for multiple qualified surgeons.
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use for same-provider return to OR for complications related to the initial `TAVR` within the global period.
`80`	Assistant surgeon	Use when an assistant surgeon performs part of the procedure.
`81`	Minimum assistant surgeon	Use when assistant involvement is minimal but reportable.
`82`	Assistant surgeon (when a qualified resident surgeon is not available)	Use when an assistant surgeon is used due to lack of resident coverage.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when a qualified non-physician assistant provides surgical assistance and reporting is required.

Taxonomy Code	Specialty	Notes
`334P00000X`	Interventional Cardiology	Primary specialty performing transcatheter valve implantation.
`208000000X`	Cardiothoracic Surgery	Surgical consultants for vascular access and complex cases; may perform open access exposure.
`207RP1001X`	Interventional Cardiology - Adult	Subspecialty taxonomy commonly used for structural heart interventions.
`207L00000X`	Cardiology	Referring and evaluating cardiology providers involved in pre- and post-procedure care.
`217T00000X`	Cardiovascular Thoracic Surgery	Cardiac surgical team participation for high-risk or hybrid procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I35.0`	Nonrheumatic aortic (valve) stenosis	Primary indication for transcatheter aortic valve implantation.
`I35.2`	Nonrheumatic aortic (valve) stenosis with insufficiency	Mixed stenosis and regurgitation presentations that may require valve replacement.
`I06.0`	Rheumatic aortic stenosis	Rheumatic valve disease occasionally treated with valve replacement when present in elderly patients.
`I97.1`	Postprocedural disorders of cardiac valves, not elsewhere classified	Used for postprocedural complications related to valve procedures.
`I48.91`	Unspecified atrial fibrillation	Common comorbidity requiring peri-procedural management and anticoagulation planning.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33405`	Replacement, aortic valve, with cardiopulmonary bypass (AVR, open surgical replacement)	Alternative definitive surgical approach for aortic valve disease; may be chosen for patients not suitable for `TAVR` or if intraoperative conversion is required.
`33210`	Insertion of temporary transvenous pacemaker, transvenous electrode(s)	May be performed pre- or intra-procedurally for management of conduction disturbances during valve deployment.
`92980`	Transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; percutaneous, with or without intravascular ultrasound	Not specific to TAVR but represents percutaneous transcatheter interventions that may be performed concurrently if coronary disease is treated during the same hospitalization (separate coding rules apply).
`36415`	Collection of venous blood by venipuncture	Routine diagnostic laboratory sampling performed pre- and post-procedure.
`51798`	Reinsertion of urinary catheter, without anesthesia	Common perioperative ancillary procedure for monitoring urine output in the perioperative period.

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