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CPT 33929: Removal of Total Artificial Heart for Donor Heart Transplant

CPT code 33929 reports the surgical removal of a total artificial heart (TAH) as a preparatory step for donor heart transplantation. This distinct procedure is reported in addition to the primary transplant code and captures the operative work required to explant the TAH and ready the chest for donor heart implantation. Nationally, accurate use of this code affects hospital surgical reporting, resource allocation in complex cardiac transplant cases, and downstream claims processing for high-acuity services.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for TAH explantation, common billing considerations, and typical sites of service for the procedure. The publication summarizes benchmark elements relevant to hospital billing for cardiac transplantation preparatory steps, highlights frequently encountered documentation needs, and outlines common modifiers associated with complex surgical services. It also points to where readers can expect to find policy updates and payer-specific coverage nuances.

This material is intended for hospital coders, clinical administrators, and provider billing teams seeking a clear reference for reporting CPT code 33929 in the context of donor heart transplantation workflows.

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Billing Code Overview

CPT code 33929 describes the surgical removal of a total artificial heart (TAH) to prepare the patient for implantation of a donor heart during a transplant procedure. This service is an intraoperative preparatory step and is reported in addition to the code for the primary transplant procedure.

Service type: Surgical, transplant preparatory procedure

Typical site of service: Hospital inpatient operating room

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CPT 33929: Removal of Total Artificial Heart for Donor Heart Transplant

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Billing Code Overview

Service type: Surgical, transplant preparatory procedure

Typical site of service: Hospital inpatient operating room

Clinical & Coding Specifications

Clinical Context

A typical patient is a 40–65-year-old with end-stage biventricular heart failure supported with a total artificial heart (TAH) who is listed for orthotopic heart transplantation. The patient presents to the operating room when a suitable donor heart becomes available. The clinical workflow includes preoperative assessment by the transplant cardiothoracic surgery team and anesthesiology, verification of donor organ compatibility, induction of general endotracheal anesthesia, median sternotomy or reopening of prior sternotomy, explantation of the TAH device with careful removal of driveline and device components, debridement of recipient cardiac and mediastinal tissues as needed, preparation of the recipient for donor organ implantation, and coordination with cardiac perfusion and transplant teams. Intraoperative steps involve hemostasis, assessment of vascular structures for anastomosis, and transfer of the patient to the intensive care unit postoperatively for hemodynamic support and immunosuppression initiation. Report 33929 in addition to the primary transplant procedure code to document removal of the TAH prior to donor heart implantation.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when removal of the TAH required substantially greater effort or complexity than typical (extensive adhesiolysis, unexpected reconstruction) and documentation supports the increased work.
`23`	Unusual anesthesia	Use when general anesthesia is medically contraindicated and an unusual anesthesia circumstance is documented for the TAH explant.
`50`	Bilateral procedure	Not typically applicable but may be used for coding systems that require bilateral notation for paired procedures if applicable to concomitant bilateral interventions.
`52`	Reduced services	Use when the TAH removal was partially performed or aborted but some work was completed.
`53`	Discontinued procedure	Use when the TAH removal was initiated but discontinued due to patient instability or intraoperative circumstance.
`62`	Two surgeons	Use when two surgeons of different specialties (e.g., cardiothoracic transplant surgeon and mechanical circulatory support specialist) perform distinct portions of the explant.
`66`	Surgical team	Use when a surgical team approach is documented for complex TAH explantation requiring multiple attending surgeons.
`78`	Unplanned return to OR following initial procedure	Use when the patient returns to the operating room for repeat TAH removal or management related to the initial explant during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon provides significant intraoperative assistance during the TAH removal.
`81`	Minimum assistant surgeon	Use when minimal assistant participation is documented.
`82`	Assistant surgeon (when qualified resident not available)	Use when a qualified resident is not available and an assistant surgeon is required.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use when a qualifying non-physician practitioner provides operative assistance as allowed by payer policy.

Taxonomy Code	Specialty	Notes
`2080S0001X`	Thoracic Surgery	Primary specialty performing TAH explant and transplantation.
`2080P0206X`	Cardiac Surgery	Cardiac transplant surgeons who manage device explant and donor implantation.
`2084P0800X`	Critical Care Medicine	Perioperative management and postoperative ICU care for transplant recipients.
`207L00000X`	Cardiovascular Disease (Cardiology)	Heart failure/transplant cardiologists managing candidacy and perioperative cardiac care.
`363L00000X`	Anesthesiology	Cardiac anesthesiologists providing intraoperative anesthesia and hemodynamic management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.84`	End-stage (chronic) heart failure	Common indication for TAH implantation and subsequent removal for transplant.
`I50.33`	Acute on chronic systolic (congestive) heart failure	Reflects progressive ventricular failure leading to mechanical circulatory support and transplant.
`I97.1`	Other intraoperative cardiac complications	May be used for coding intraoperative events related to device explant and transplant.
`Z94.1`	Heart transplant status	Used post-transplant for documentation of transplant recipient status; relevant after donor heart implantation.
`T82.898A`	Other complications of cardiac prosthetic device, initial encounter	Captures complications related to the TAH that necessitate explant prior to transplant.
`Z48.22`	Encounter for removal of cardiac device	Administrative code to indicate removal of an implanted cardiac device such as a TAH.
`Z95.2`	Presence of prosthetic heart valve	Relevant in complex surgical histories though not specific to TAH, may appear in patient records.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33945`	Heart transplantation, orthotopic; with cardiopulmonary bypass	Primary code for donor heart implantation commonly performed immediately after `33929` (TAH removal).
`33930`	Reoperation for heart transplantation; with cardiopulmonary bypass	Used when a reoperative transplant is performed; may follow TAH removal in re-transplant settings.
`33933`	Heart retransplantation, orthotopic; with cardiopulmonary bypass	Applied when replacing a prior transplanted heart; TAH removal (`33929`) may be performed prior to retransplant.
`33940`	Implantation of a total artificial heart	Represents the prior implantation of the TAH; documented historically and relevant to continuity of care and device management.
`00530`	Anesthesia for procedures on heart; open, not including cardiac transplantation	Anesthesia services commonly reported for the TAH explant and transplant procedures; anesthesia coding varies by payer and setting.

CPT 33927: Total Artificial Heart Implantation

CPT-33928-ARTIFICIAL-HEART-EXCHANGE-IMPLANTATION

CPT 33928: Removal and Replacement of Implanted Artificial Heart

CPT-33930-DONOR-HEART-AND-LUNG-PROCUREMENT-CARDIECTOMY-PNEUMONECTOMY

CPT 33930: Donor Heart and Lung Procurement (Cardiectomy and Pneumonectomy)

CPT-33933-DONOR-HEART-AND-LUNG-PREPARATION-FOR-TRANSPLANTATION

CPT 33933: Donor Heart and Lung Preparation for Transplantation

CPT-33935-HEART-LUNG-TRANSPLANTATION

CPT 33935: Combined Heart and Lung Transplantation

CPT-33940-CARDIECTOMY-DONOR-HEART-FOR-TRANSPLANT

CPT 33940: Cardiectomy for Heart Transplant

CPT-33944-DONOR-HEART-PREPARATION-FOR-TRANSPLANTATION

CPT 33944: Donor Heart Preparation for Transplantation

CPT-33945-HEART-TRANSPLANT-RECIPIENT-IMPLANTATION-CARDIECTOMY

CPT 33945: Heart Transplantation with Recipient Cardiectomy

Frequently Asked Questions

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when removal of the TAH required substantially greater effort or complexity than typical (extensive adhesiolysis, unexpected reconstruction) and documentation supports the increased work.
`23`	Unusual anesthesia	Use when general anesthesia is medically contraindicated and an unusual anesthesia circumstance is documented for the TAH explant.
`50`	Bilateral procedure	Not typically applicable but may be used for coding systems that require bilateral notation for paired procedures if applicable to concomitant bilateral interventions.
`52`	Reduced services	Use when the TAH removal was partially performed or aborted but some work was completed.
`53`	Discontinued procedure	Use when the TAH removal was initiated but discontinued due to patient instability or intraoperative circumstance.
`62`	Two surgeons	Use when two surgeons of different specialties (e.g., cardiothoracic transplant surgeon and mechanical circulatory support specialist) perform distinct portions of the explant.
`66`	Surgical team	Use when a surgical team approach is documented for complex TAH explantation requiring multiple attending surgeons.
`78`	Unplanned return to OR following initial procedure	Use when the patient returns to the operating room for repeat TAH removal or management related to the initial explant during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon provides significant intraoperative assistance during the TAH removal.
`81`	Minimum assistant surgeon	Use when minimal assistant participation is documented.
`82`	Assistant surgeon (when qualified resident not available)	Use when a qualified resident is not available and an assistant surgeon is required.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use when a qualifying non-physician practitioner provides operative assistance as allowed by payer policy.

Taxonomy Code	Specialty	Notes
`2080S0001X`	Thoracic Surgery	Primary specialty performing TAH explant and transplantation.
`2080P0206X`	Cardiac Surgery	Cardiac transplant surgeons who manage device explant and donor implantation.
`2084P0800X`	Critical Care Medicine	Perioperative management and postoperative ICU care for transplant recipients.
`207L00000X`	Cardiovascular Disease (Cardiology)	Heart failure/transplant cardiologists managing candidacy and perioperative cardiac care.
`363L00000X`	Anesthesiology	Cardiac anesthesiologists providing intraoperative anesthesia and hemodynamic management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.84`	End-stage (chronic) heart failure	Common indication for TAH implantation and subsequent removal for transplant.
`I50.33`	Acute on chronic systolic (congestive) heart failure	Reflects progressive ventricular failure leading to mechanical circulatory support and transplant.
`I97.1`	Other intraoperative cardiac complications	May be used for coding intraoperative events related to device explant and transplant.
`Z94.1`	Heart transplant status	Used post-transplant for documentation of transplant recipient status; relevant after donor heart implantation.
`T82.898A`	Other complications of cardiac prosthetic device, initial encounter	Captures complications related to the TAH that necessitate explant prior to transplant.
`Z48.22`	Encounter for removal of cardiac device	Administrative code to indicate removal of an implanted cardiac device such as a TAH.
`Z95.2`	Presence of prosthetic heart valve	Relevant in complex surgical histories though not specific to TAH, may appear in patient records.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33945`	Heart transplantation, orthotopic; with cardiopulmonary bypass	Primary code for donor heart implantation commonly performed immediately after `33929` (TAH removal).
`33930`	Reoperation for heart transplantation; with cardiopulmonary bypass	Used when a reoperative transplant is performed; may follow TAH removal in re-transplant settings.
`33933`	Heart retransplantation, orthotopic; with cardiopulmonary bypass	Applied when replacing a prior transplanted heart; TAH removal (`33929`) may be performed prior to retransplant.
`33940`	Implantation of a total artificial heart	Represents the prior implantation of the TAH; documented historically and relevant to continuity of care and device management.
`00530`	Anesthesia for procedures on heart; open, not including cardiac transplantation	Anesthesia services commonly reported for the TAH explant and transplant procedures; anesthesia coding varies by payer and setting.

CPT 33927: Total Artificial Heart Implantation

CPT-33928-ARTIFICIAL-HEART-EXCHANGE-IMPLANTATION

CPT 33928: Removal and Replacement of Implanted Artificial Heart

CPT-33930-DONOR-HEART-AND-LUNG-PROCUREMENT-CARDIECTOMY-PNEUMONECTOMY

CPT 33930: Donor Heart and Lung Procurement (Cardiectomy and Pneumonectomy)

CPT-33933-DONOR-HEART-AND-LUNG-PREPARATION-FOR-TRANSPLANTATION

CPT 33933: Donor Heart and Lung Preparation for Transplantation

CPT-33935-HEART-LUNG-TRANSPLANTATION

CPT 33935: Combined Heart and Lung Transplantation

CPT-33940-CARDIECTOMY-DONOR-HEART-FOR-TRANSPLANT

CPT 33940: Cardiectomy for Heart Transplant

CPT-33944-DONOR-HEART-PREPARATION-FOR-TRANSPLANTATION

CPT 33944: Donor Heart Preparation for Transplantation

CPT-33945-HEART-TRANSPLANT-RECIPIENT-IMPLANTATION-CARDIECTOMY

CPT 33945: Heart Transplantation with Recipient Cardiectomy

Frequently Asked Questions

References

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.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.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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CPT 33929: Removal of Total Artificial Heart for Donor Heart Transplant

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Billing Code Overview

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CPT 33929: Removal of Total Artificial Heart for Donor Heart Transplant

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 33929: Removal of Total Artificial Heart for Donor Heart Transplant

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Billing Code Overview

CPT 33929: Removal of Total Artificial Heart for Donor Heart Transplant

Sign up for cpt 33929 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

When should CPT 33929 be reported?

How does 33929 relate to other transplant CPT codes listed?

Which modifiers are commonly noted for 33929 and what documentation is required?

What clinical setting and provider specialties are associated with 33929?

Which payers are noted and are there payer-specific considerations mentioned for 33929?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

When should CPT 33929 be reported?

How does 33929 relate to other transplant CPT codes listed?

Which modifiers are commonly noted for 33929 and what documentation is required?

What clinical setting and provider specialties are associated with 33929?

Which payers are noted and are there payer-specific considerations mentioned for 33929?

References