CPT 33929 Total Artificial Heart Removal Reimbursement | OpenPayer

Summary & Overview

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.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare33929CPTcardiac-surgerytransplantationtotal-artificial-heartoperative-procedureinpatient-surgerybilling-and-coding

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

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.

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

CPT-33927-TOTAL-ARTIFICIAL-HEART-IMPLANTATION

CPT 33927: Total Artificial Heart Implantation

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

CPT 33944: Donor Heart Preparation for Transplantation

CPT-33928-ARTIFICIAL-HEART-EXCHANGE-IMPLANTATION

CPT 33928: Removal and Replacement of Implanted Artificial Heart

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

CPT 33940: Cardiectomy for Heart Transplant

33945-HEART-TRANSPLANT-WITH-OR-WITHOUT-RECIPIENT

CPT 33945: Heart Transplant Surgery, With or Without Cardiectomy

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.

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