Summary & Overview
CPT 33927: Total Artificial Heart Implantation
CPT code 33927 represents surgical implantation of a total artificial heart, including explantation of the native heart, used either as a temporary bridge to transplantation or as permanent mechanical circulatory support for patients ineligible for transplant. This high-acuity cardiac surgical procedure is concentrated in specialized inpatient settings and has significant clinical and financial implications given the complexity, resource intensity, and implications for patient selection and long-term care.
Key national payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code denotes, the clinical context for use, and the typical care setting. The publication summarizes benchmarking and utilization considerations, common billing modifiers and coding nuances where available, and policy-relevant issues affecting coverage and provider reimbursement. It also outlines themes relevant to clinical pathways, hospital resource planning, and payer policy without state-specific detail.
Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, and service-line level detail is identified where applicable.
Billing Code Overview
CPT code 33927 describes the surgical removal of a patient’s native heart and implantation of an artificial heart. This procedure is performed as a temporary measure while a donor heart is sought or as permanent mechanical cardiac support for patients who are not candidates for heart transplantation.
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Service type: Surgical implantation of a total artificial heart for circulatory support
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Typical site of service: Inpatient, tertiary care centers or specialized cardiac surgery hospitals where advanced mechanical circulatory support is provided
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with end-stage heart failure presents with refractory cardiogenic shock despite maximal medical therapy and temporary mechanical circulatory support. The multidisciplinary heart failure team (cardiothoracic surgeon, advanced heart failure cardiologist, perfusionist, and critical care specialists) determines that the patient requires urgent implantation of a total artificial heart as a bridge to transplant. The patient is taken to the operating room, placed on cardiopulmonary bypass, the native heart is explanted, and a temporary total artificial heart device is implanted. Postoperative care occurs in a cardiac surgical intensive care unit with continuous hemodynamic monitoring, anticoagulation management, and preparation for transfer to an approved transplant center or long-term mechanical circulatory support program if the device is intended as destination therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard use when no additional reporting modifiers apply |
11 | Primary procedure | When 33927 is the principal service for the encounter |