Summary & Overview
CPT 33504: Repair of Anomalous Coronary Artery Origin with Graft
CPT code 33504 denotes open surgical repair of a coronary artery that originates from the pulmonary artery, performed with the patient on cardiopulmonary bypass using a graft to reestablish coronary perfusion. This complex cardiothoracic procedure is clinically significant because it addresses congenital or acquired coronary anomalies that can cause myocardial ischemia and congestive heart failure; timely surgical correction can be lifesaving and may prevent progressive cardiac dysfunction. Nationally, the code represents high-acuity inpatient cardiac surgery typically billed to major commercial payers and Medicare.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, expected site-of-service and service type, and a summary of what to expect in payer coverage and billing practice. The publication outlines common billing modifiers associated with complex surgical services and points to related clinical and coding considerations. It is intended to help health system billing staff, clinical coders, and policy analysts understand the code’s clinical role and where it fits in inpatient cardiac surgical service lines.
Data not available in the input: Associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific reimbursement benchmarks.
Billing Code Overview
CPT code 33504 describes a surgical procedure performed with the patient on cardiopulmonary bypass to repair a coronary artery that arises abnormally from the pulmonary artery using a graft. The procedure is intended to restore or improve coronary blood flow and to treat congestive heart failure or ischemia resulting from the anomalous origin.
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Service type: Open cardiac surgical correction of anomalous coronary artery origin with grafting, performed on cardiopulmonary bypass
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Typical site of service: Inpatient hospital operating room with cardiothoracic surgical team and cardiopulmonary bypass support
Clinical & Coding Specifications
Clinical Context
A 6-month-old infant presents with failure to thrive, tachypnea, hepatomegaly, and signs of congestive heart failure. Echocardiography demonstrates a coronary artery arising anomalously from the pulmonary artery with associated myocardial ischemia and left ventricular dysfunction. After multidisciplinary discussion, the cardiothoracic surgery team schedules corrective repair under cardiopulmonary bypass. In the operating room, the patient is placed on cardiopulmonary bypass, the anomalous coronary is mobilized, and a graft conduit is used to re-establish coronary blood flow from the aorta to the aberrant coronary origin. Intraoperative transesophageal echocardiography confirms improved myocardial perfusion and ventricular function. Postoperative care includes intensive care unit monitoring, inotropic support as needed, serial cardiac biomarkers, telemetry, and follow-up echocardiography to assess graft patency and ventricular recovery. Discharge planning includes outpatient cardiology follow-up and imaging surveillance for graft function and growth-related issues.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | Use when no special circumstances or modifiers apply to the service. |
11 |