Summary & Overview
CPT 33369: Cardiopulmonary Bypass with Central Cannulation During TAVI/TAVR
CPT code 33369 designates cardiopulmonary bypass (CPB) with central arterial and venous cannulation when performed during a primary transcatheter aortic valve implantation/replacement (TAVI/TAVR). This intraoperative service code captures an advanced cardiac support technique used when CPB is required to manage hemodynamics or facilitate complex valve implantation. Nationally, accurate use of this code affects hospital procedure reporting, case mix classification, and payment for high-acuity structural heart interventions.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, plus what to expect in a fuller analysis: benchmark metrics for utilization, documentation and coding considerations, and potential policy or payer coverage implications. The full publication will cover how 33369 interacts with procedural reporting for TAVI/TAVR, common billing scenarios, and areas where clearer documentation supports appropriate claim adjudication.
This summary is written for a national audience of clinicians, coders, and policy analysts seeking a practical reference to the code's clinical meaning and relevance to hospital-based structural heart services. Data not available in the input will be identified in the detailed sections of the full report.
Billing Code Overview
CPT code 33369 describes the use of cardiopulmonary bypass (CPB) during a primary transcatheter aortic valve implantation/replacement (TAVI/TAVR) service. This code is specific to CPB that uses central arterial and venous cannulation performed in conjunction with the TAVI/TAVR procedure.
Service type: Intraoperative cardiopulmonary bypass during primary TAVI/TAVR
Typical site of service: Hospital inpatient or operating room setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a frail older adult with severe, symptomatic aortic stenosis referred for transcatheter aortic valve implantation/replacement (TAVI/TAVR). Pre-procedure evaluation includes cardiology assessment, transthoracic and transesophageal echocardiography, coronary angiography as indicated, CT angiography for annular sizing, and multidisciplinary heart team review. On the day of service the patient is brought to a hybrid operating room or cardiac catheterization lab converted for open support. General endotracheal anesthesia is induced. Vascular access is obtained and the team performs the TAVI/TAVR. Due to intra-procedural instability, complex anatomy, or planned central cannulation strategy, the surgical team initiates cardiopulmonary bypass (CPB) using central arterial and venous cannulation. CPB is used to support circulation and oxygenation while the valve deployment, removal of calcific material, or conversion to open repair is undertaken. The patient is weaned from CPB, decannulated, hemostasis is achieved, and the patient is transferred to the cardiac intensive care unit for post‑operative monitoring and hemodynamic support.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard claim submission | Use when no special circumstances apply to the service. |
11 |