Summary & Overview
CPT 33370: Cerebral Embolic Protection During TAVR
CPT code 33370 covers percutaneous placement of cerebral embolic protection devices during the same session as a primary transcatheter aortic valve replacement (TAVR/TAVI). This adjunctive procedural code captures a preventative intervention intended to reduce periprocedural cerebral embolic events, a clinically significant concern for TAVR patients given the risk of stroke and neurocognitive injury.
Key national payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and payment policies for adjunctive cerebral protection vary across commercial plans and Medicare, with differences driven by evidence assessment, coding guidance, and bundled payment arrangements for TAVR episodes.
Readers will gain a concise overview of what 33370 represents clinically and operationally, typical sites of service, and which major payers are relevant to coverage discussions. The publication also outlines where to find benchmarks, common modifiers, and policy-relevant updates that affect billing and reimbursement for adjunctive embolic protection during TAVR. Data not available in the input is noted where applicable, and the piece is intended as a national-level reference for coding, clinical context, and payer policy considerations.
Billing Code Overview
CPT code 33370 describes placement of one or more cerebral embolic protection devices percutaneously during the same session as a primary transcatheter aortic valve replacement (TAVR/TAVI) procedure. The service is intended to reduce the risk of embolic debris and thrombus reaching the cerebral circulation during valve implantation.
Service type: Interventional vascular procedure performed adjunctive to TAVR/TAVI
Typical site of service: Hospital operating room or cardiac catheterization / hybrid suite, provided at the time of the TAVR/TAVI admission and performed by the interventional cardiology or cardiothoracic procedural team.
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult with severe, symptomatic aortic stenosis scheduled for a primary transcatheter aortic valve replacement (TAVR/TAVI). Because TAVR can dislodge calcific debris and thrombus that may embolize to the cerebral circulation, the interventional team elects to place a percutaneous cerebral embolic protection device during the same session. The workflow: pre-procedure evaluation in the structural heart clinic including imaging (echocardiography, CT angiography), informed consent discussing embolic protection, anticoagulation/antiplatelet management, and vascular access planning. In the hybrid operating room or catheterization lab, vascular access is obtained (typically femoral arterial for TAVR and radial or femoral access for the protection device), the cerebral protection device is deployed across the brachiocephalic and left common carotid origins (or equivalent per device instructions), a TAVR valve is delivered and deployed, and finally the protection device is retrieved and inspected for captured debris. Post-procedure monitoring occurs in the post-anesthesia care unit or cardiac ICU with neurologic checks, vascular site assessment, and standard TAVR follow-up including echocardiography before discharge.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician's professional interpretation or performance portion if separate technical work is billed elsewhere |