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    v1.0.28
    OpenPayerBilling CodesSurgical Procedures on the Aortic ValveCPT cpt-33410-stentless-aortic-valve-replacement
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    CPT 33410: Aortic Valve Replacement with Stentless Prosthesis

    Medicare pays $2394 and commercial payers pay $3101 on average nationally for this procedure.

    CPT code 33410 describes surgical replacement of the aortic valve with an artificial stentless valve to treat aortic valve stenosis or regurgitation; this is an open cardiac surgical procedure (aortic valve replacement) performed in an operating room or cardiac surgical suite and involves excision of the diseased valve and implantation of a stentless prosthetic to restore valve function and optimize blood flow.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    National Reimbursement Benchmarks

    Medicare’s national mean rate of $2394 sits notably below BUCA’s average commercial mean of $3100.6, indicating that commercial BUCA contracts pay about $706.6 more on average for CPT 33410 than Medicare. The gap highlights a meaningful separation between Medicare reimbursement and one representative commercial aggregator; other commercial payers (e.g., Cigna, UnitedHealth Group) show even higher means, but the Medicare mean remains a central lower anchor at $2394.

    Dispersion measured by the interquartile range (P75–P25) varies considerably across payers: Blue Cross Blue Shield has a range of $1,741.7, UnitedHealth Group $2,826.6, Cigna $2,735.5, Aetna $2,299.0, and BUCA $2,183.6. UnitedHealth Group displays the widest IQR, indicating the greatest middle-50% variability, while Blue Cross Blue Shield is the tightest among the named commercial payers. Medicare’s IQR is $190, reflecting relatively low middle-range variation compared with commercial payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old patient with progressive aortic valve disease presents with symptomatic aortic stenosis characterized by exertional dyspnea, angina, and syncope. Preoperative evaluation includes transthoracic and transesophageal echocardiography confirming severe aortic valve stenosis with reduced valve area and elevated gradients; coronary angiography to assess for concomitant coronary artery disease; and routine laboratory testing and chest imaging. The cardiothoracic surgical team plans an open surgical aortic valve replacement using a stentless prosthetic valve (33410) under general anesthesia with cardiopulmonary bypass. The intraoperative workflow includes median sternotomy, aortotomy, excision of the diseased native valve, sizing for a stentless valve, implantation of the stentless prosthesis, valve competency testing, decannulation, and chest closure. Postoperative care occurs in the cardiothoracic intensive care unit for hemodynamic monitoring, anticoagulation management as indicated, and echocardiographic assessment prior to discharge and follow-up in the cardiology clinic. Typical payors for authorization and claims for this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    33405Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograftAlternative aortic valve replacement code for prosthetic valves; clinically related as a substitute when the valve used is stented rather than stentless.

    Related Modifiers

    14 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Showing 1–10 of 14

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianA thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the su…
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    208600000XSurgery PhysicianA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of s…
    282NR1301XRural Acute Care HospitalHospitals · General Acute Care Hospital
    209800000XLegal Medicine (M.D./D.O.) PhysicianLegal Medicine is a special field of medicine that focuses on various aspects of medicine and law. Historically, the practice of legal medicine made c…
    1223E0200XEndodonticsThe branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study…
    364SA2100XAcute Care Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    3418M1120XMilitary or U.S. Coast Guard Air Transport AmbulanceVehicle and staff for patient emergency or non-emergency air transport.

    Related ICD-10-CM Codes

    30 rows

    ICD-10-CM CodeDescription
    I05.0Rheumatic mitral stenosis
    I05.1Rheumatic mitral insufficiency
    I06.0Rheumatic aortic stenosis
    I06.1Rheumatic aortic insufficiency
    I08.0Rheumatic disorders of both mitral and aortic valves
    I08.1Rheumatic disorders of both mitral and tricuspid valves
    I08.2Rheumatic disorders of both aortic and tricuspid valves
    I09.1Rheumatic diseases of endocardium, valve unspecified
    I21.09ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
    I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris

    Showing 1–10 of 30

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    Related Codes

    CPT-33361-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-FEMORAL

    CPT 33361: Transfemoral Transcatheter Aortic Valve Implantation (TAVR)

    CPT-33362-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-OPEN-FEMORAL-APPROACH

    CPT 33362: Transcatheter Aortic Valve Replacement, Open Femoral Artery Approach

    CPT-33363-TAVR-TAVI-OPEN-AXILLARY-ARTERY-APPROACH

    CPT 33363: Transcatheter Aortic Valve Replacement, Open Axillary Approach

    CPT-33364-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-ILIAC-ARTERY-APPROACH

    CPT 33364: Transcatheter Aortic Valve Replacement, Open Iliac Approach

    CPT-33365-TRANSAORTIC-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-TAVR

    CPT 33365: Transaortic Transcatheter Aortic Valve Replacement

    CPT-33366-TRANSAPICAL-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-TAVR-TAVI

    CPT 33366: Transapical Transcatheter Aortic Valve Replacement

    CPT-33367-CPB-DURING-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT

    CPT 33367: Cardiopulmonary Bypass for Percutaneous Cannulation in TAVI/TAVR

    CPT-33368-CARDIOPULMONARY-BYPASS-DURING-TAVI-TAVR-OPEN-PERIPHERAL-CANNULATION

    CPT 33368: Cardiopulmonary Bypass for TAVI/TAVR with Open Peripheral Cannulation

    CPT-33369-CPB-CENTRAL-CANNULATION-DURING-TAVR

    CPT 33369: Cardiopulmonary Bypass for TAVI/TAVR with Central Cannulation

    CPT-33370-CEREBRAL-EMBOLIC-PROTECTION-TAVR

    CPT 33370: Cerebral Embolic Protection Placement During TAVR

    Showing 1–10 of 23

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    33406Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograftRelated procedural code describing aortic valve replacement with cardiopulmonary bypass for other prosthetic valve types; used in the same clinical pathway when coding differs by valve type.