Summary & Overview
CPT 33405: Surgical Replacement of Aortic Valve with Prosthetic Device
CPT code 33405 represents the surgical replacement of the aortic valve with a prosthetic device, excluding homograft or stentless valves, utilizing cardiopulmonary bypass. This procedure is a cornerstone of cardiothoracic surgery, addressing critical aortic valve conditions such as stenosis and insufficiency. The code is widely recognized across major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, reflecting its importance in both clinical and reimbursement contexts.
This publication provides a comprehensive overview of 33405, including payer coverage, clinical indications, and related coding benchmarks. Readers will gain insight into the procedural context, typical site of service, and how this code fits within broader surgical and cardiovascular care pathways. Policy updates, coding nuances, and comparisons to related procedures are also discussed, offering a clear understanding of how 33405 is utilized in hospital settings nationwide. The analysis is designed to inform stakeholders about current trends, payer policies, and clinical relevance, supporting informed decision-making in medical billing and healthcare administration.
CPT Code Overview
CPT code 33405 describes the replacement of the aortic valve with a prosthetic valve, excluding homograft or stentless valves, performed with cardiopulmonary bypass. This procedure is a key component of cardiothoracic surgery and is typically conducted in an inpatient hospital setting (Place of Service 21). The operation addresses severe aortic valve disease and is essential for patients requiring surgical intervention to restore normal cardiac function.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient admitted to an inpatient hospital with severe symptomatic aortic valve disease, such as aortic stenosis or aortic insufficiency. The patient may present with symptoms including chest pain, shortness of breath, or syncope. After diagnostic evaluation confirms the need for surgical intervention, the patient undergoes replacement of the aortic valve using a prosthetic valve (other than homograft or stentless valve) with cardiopulmonary bypass. The procedure is performed by a cardiothoracic surgeon in a hospital operating room setting.
Coding Specifications
Modifiers:
| Modifier Code | Description | When Used |
|---|---|---|
22 | Increased Procedural Services | When the procedure requires significant additional work beyond typical services. |
51 | Multiple Procedures | When more than one procedure is performed during the same operative session. |
Provider Taxonomies: