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CPT 33405: Aortic Valve Replacement, Open with Cardiopulmonary Bypass
CPT code 33405 represents open surgical replacement of the aortic valve with a prosthetic (non-homograft, non-ventless) valve performed with cardiopulmonary bypass. This is a high-acuity inpatient cardiac surgery used to treat aortic valve disease such as stenosis or insufficiency; it carries substantial clinical and resource implications because it requires cardiopulmonary bypass, specialized surgical teams, and intensive postoperative care. Nationally, aortic valve replacement procedures are central to cardiovascular surgical services and influence hospital surgical capacity, bundled payment arrangements, and payer coverage policies.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of the code’s clinical meaning, the common settings where the service is delivered, and how the code relates to other aortic valve interventions. The publication covers benchmark considerations, common procedural groupings, and pertinent clinical context to help coding, billing, and clinical teams align documentation and claim submission to the code definition. The content is intended for a national audience of health plan analysts, hospital revenue cycle professionals, and clinical leaders seeking clear coding guidance and context for utilization and policy discussions.
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Billing Code Overview
CPT code 33405 describes an open surgical replacement of the aortic valve with an artificial (prosthetic) valve performed with the patient on cardiopulmonary bypass. The procedure involves removing the diseased native aortic valve and implanting a non-homograft, non-ventless prosthetic valve to restore effective left ventricular outflow and systemic blood flow.
Service type: Surgical — Open cardiac valve replacement
Typical site of service: Inpatient hospital operating room with cardiopulmonary bypass support
National Reimbursement Benchmarks
National commercial averages sit above Medicare for CPT 33405: BUCA’s mean of $2,849.70 exceeds Medicare’s mean of $2,135.50 by $714.20, indicating higher commercial pricing for this procedure versus the Medicare baseline. Blue Cross Blue Shield ($2,468.10 mean), Aetna ($1,854.00 mean), Cigna ($3,707.00 mean) and UnitedHealth Group ($4,132.60 mean) span a wide commercial cost spectrum, with UnitedHealth Group at the high end and Aetna at the low end of those listed.
Dispersion measured as the interquartile range (P75–P25) varies notably: Aetna’s IQR is $2,247.90, Blue Cross Blue Shield’s is $1,595.70, BUCA’s is $1,990.60, Cigna’s is $2,410.80, and UnitedHealth Group’s is $2,478.50. Blue Cross Blue Shield is the tightest payer by IQR, while UnitedHealth Group and Cigna exhibit the widest 25–75 spreads, signaling greater rate variability among those payers.