Summary & Overview
CPT 33542: Ventricular Aneurysm Resection and Repair
CPT code 33542 represents open surgical removal of a ventricular aneurysm sac with closure of the ventricular defect, typically performed during coronary artery bypass grafting. This code captures a complex cardiac reconstructive procedure intended to strengthen the ventricular wall and prevent aneurysm rupture, with implications for operative planning, resource use, and inpatient reimbursement. Nationally, the procedure is relevant to hospitals, cardiac surgery programs, and payers managing high-acuity cardiovascular care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for the procedure, typical settings of care, and the types of benchmarks and policy elements that influence coverage and coding for complex cardiac surgery. The publication outlines how the code is used in operative reporting, expected site-of-service patterns, and the kinds of payer considerations that commonly arise for high-complexity inpatient cardiac procedures.
This summary equips clinicians, coding professionals, and payer policy staff with a national perspective on the clinical intent of CPT code 33542, the service environment where it is performed, and the areas where coding accuracy and documentation are most consequential. Data not available in the input includes specific utilization rates, payer-specific reimbursement figures, and associated ICD-10 diagnoses.
Billing Code Overview
CPT code 33542 describes a surgical procedure in which the provider opens and removes an aneurysm sac from the wall of a cardiac ventricle and sutures the defect closed to reinforce the heart wall and reduce risk of rupture. The procedure is typically performed in conjunction with coronary artery bypass grafting and other open cardiac operations.
-
Service type: Open cardiac surgical repair of ventricular aneurysm, often performed as part of coronary artery bypass graft procedures
-
Typical site of service: Inpatient hospital operating room or cardiac surgery suite
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with ischemic cardiomyopathy and a left ventricular aneurysm identified on echocardiography and cardiac MRI is admitted for elective coronary artery bypass grafting (CABG) with concomitant ventricular aneurysm repair. The patient has worsening heart failure symptoms (dyspnea on exertion, reduced exercise tolerance), a prior anterior myocardial infarction, and persistent akinetic/dyskinetic segment of the left ventricular anterior wall. Preoperative workflow includes cardiology evaluation, coronary angiography confirming multivessel coronary artery disease, preoperative anesthesia assessment, and informed consent for CABG with aneurysmectomy. In the operating room under general anesthesia, median sternotomy is performed, cardiopulmonary bypass is instituted, coronary grafts are placed, and the surgeon opens the left ventricular aneurysm sac, excises nonviable tissue, and sutures the ventricular defect closed (aneurysmectomy) to restore ventricular contour and reduce risk of rupture and thrombus. Postoperative care includes ICU monitoring, hemodynamic support, pain control, anticoagulation management as indicated, wound care, and cardiac rehabilitation planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When two surgeons from different specialties perform distinct portions of the procedure (e.g., complex concurrent procedures requiring dual primary surgeons). |