Summary & Overview
CPT 33859: Ascending Aortic Aneurysm Repair with Graft and Bypass
CPT code 33859 represents open surgical repair of an ascending aortic aneurysm using a graft with initiation of cardiopulmonary bypass. This is a high-acuity cardiothoracic procedure that often occurs in tertiary care centers and has substantial implications for hospital surgical services, resource use, and payer reimbursement policy nationally. The code captures both graft reconstruction of the ascending aorta and optional suspension of the aortic valve within the graft when performed.
Key payers in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise information on the clinical context of the procedure, the typical site of service (inpatient operating room/cardiothoracic suite), and the kinds of data and benchmarks commonly reviewed for complex aortic surgery. The publication outlines where CPT code 33859 fits within surgical service lines and what stakeholders typically evaluate: utilization patterns, facility-level resource requirements, and coding specificity related to open ascending aortic repair with bypass.
Available input did not include specific ICD-10 pairings, payer-specific reimbursement rates, or associated taxonomies; those items are noted as not available in the input. The piece is intended to orient clinicians, coders, and policy analysts to the code’s clinical meaning and operational context and to identify the areas where further payer- or institution-specific data would be required for benchmarking or policy decisions.
Billing Code Overview
CPT code 33859 describes surgical repair of an ascending aortic aneurysm using a graft with initiation of cardiopulmonary bypass. The procedure may include suspension of the aortic valve to an appropriate height within the grafted vessel when indicated.
Service Type: Open cardiothoracic surgical repair with cardiopulmonary bypass
Typical Site of Service: Inpatient operating room / cardiothoracic surgery suite
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a 6.0 cm ascending aortic aneurysm identified on CT angiography presents for elective open surgical repair. He has progressive chest pain, a history of hypertension and hyperlipidemia, and preserved left ventricular function on echocardiography. The cardiothoracic surgery team performs a median sternotomy, initiates cardiopulmonary bypass, excises the diseased ascending aortic segment, and replaces it with a synthetic tubular graft. During the procedure the surgeon may suspend or resuspend the aortic valve commissures or reimplant the valve within the graft if valve-sparing techniques are indicated. Typical perioperative workflow includes preoperative imaging and cardiology consultation, anesthesia induction with invasive monitoring, institution of cardiopulmonary bypass, aortic cross-clamping, graft replacement with or without aortic valve intervention, weaning from bypass, chest closure, and postoperative ICU care for hemodynamic monitoring and ventilatory support. Typical site of service is an inpatient tertiary care hospital operating room with post-anesthesia care unit and cardiothoracic intensive care unit admission following surgery.
Coding Specifications
- For this ascending aortic aneurysm repair procedure, the following modifiers are most clinically relevant.
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | Use when no special circumstances apply and the service is reported normally. |