Summary & Overview
CPT 33400: Open Aortic Valve Replacement with Cardiopulmonary Bypass
Headline: CPT 33400: Open Aortic Valve Replacement with Cardiopulmonary Bypass
Lead: CPT 33400 denotes open surgical replacement of the aortic valve performed with cardiopulmonary bypass, a high-acuity cardiothoracic procedure that remains a cornerstone treatment for severe aortic valve disease. It is typically performed in the inpatient hospital setting and has broad implications for surgical practice, hospital resource use, and payer coverage.
CPT 33400 represents definitive surgical management for aortic valve pathology when valve repair or less invasive options are not appropriate. Nationally, this code is significant because it captures a resource-intensive procedure associated with substantial perioperative care, operating room time, and postoperative inpatient recovery. The analysis covers major commercial payers and their approaches to coverage and reimbursement for surgical valve replacement.
Key payers included in this review are Blue Cross Blue Shield and Cigna Health. Readers will find an overview of clinical context, coding and billing considerations, commonly associated procedure and diagnosis groupings, and related CPT codes that are frequently documented in the perioperative course. The publication outlines operational and coding touchpoints relevant to hospitals and cardiothoracic surgeons, and it highlights where additional local payer policy review may be needed.
This summary provides a concise reference for clinicians, coding professionals, and hospital administrators seeking a national-level understanding of CPT 33400 and its role in contemporary cardiac surgical care.
CPT Code Overview
CPT 33400 describes replacement of the aortic valve via an open approach performed with cardiopulmonary bypass. This procedure is a cardiothoracic surgical intervention that involves removing a diseased aortic valve and implanting a replacement prosthetic valve while the patient is supported by cardiopulmonary bypass.
Service Type: Cardiothoracic Surgery
Typical Site of Service: Inpatient Hospital (POS 21)
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient presents with symptomatic aortic valve disease (exertional dyspnea, angina, or syncope) and echocardiographic confirmation of severe aortic stenosis or mixed aortic stenosis/insufficiency. Preoperative evaluation includes cardiac catheterization to assess coronary anatomy, transthoracic or transesophageal echocardiography for valve morphology and function, and multidisciplinary review by cardiothoracic surgery and cardiovascular medicine. The patient is admitted to the inpatient hospital (POS 21) for preoperative optimization, undergoes general endotracheal anesthesia, median sternotomy, cardiopulmonary bypass, excision of the native aortic valve, and placement of a prosthetic aortic valve. Postoperative care includes intensive care unit monitoring, hemodynamic support, rhythm surveillance, and discharge planning with follow-up.
Coding Specifications
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Modifiers
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22: Increased Procedural Services — Use when the work, time, technical difficulty, or risk of the procedure is substantially greater than typically required for33400; documentation must support the reason for increased services. -
63: Procedure performed on infants less than 4 kg — Use when33400is performed on an infant weighing under 4 kilograms; documentation must state the infant's weight. -
Provider Taxonomies