Summary & Overview
CPT 33967: Percutaneous Insertion of Intra–Aortic Balloon Catheter
CPT code 33967 represents the percutaneous insertion of an intra–aortic balloon catheter to provide mechanical circulatory support in patients with compromised systemic or coronary blood flow. Nationally, this code is used in acute cardiac care settings where rapid hemodynamic support is required, including cardiac catheterization laboratories and operating rooms. The procedure is a key intervention for cardiogenic shock and other critical ischemic states and has implications for hospital resource use, device utilization, and acute care quality measures.
Key payers covered in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, plus benchmarking insights and policy-relevant considerations related to procedure utilization and coverage. The report summarizes allowed payment benchmarks, common billing practices, and relevant coding considerations for institutions and billing professionals. It also highlights areas where policy updates or payer-specific requirements commonly affect claims adjudication.
This national-level summary is intended for hospital administrators, cardiovascular program directors, and revenue cycle professionals seeking a clear, practical briefing on CPT code 33967—what it denotes, where it is performed, and why it matters for acute cardiac care delivery and reimbursement.
Billing Code Overview
CPT code 33967 describes the percutaneous insertion of an intra–aortic balloon catheter into the aorta to provide mechanical circulatory support for patients with interrupted or critically reduced blood supply. This procedure involves placement of a catheter-based balloon device to augment coronary and systemic perfusion by inflating and deflating in synchrony with the cardiac cycle.
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Service type: Percutaneous mechanical circulatory support procedure
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Typical site of service: Hospital operating room or cardiac catheterization laboratory, often performed in settings that provide invasive cardiac support such as cardiac surgery suites or advanced interventional cardiology labs
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of ischemic cardiomyopathy and acute decompensated heart failure is admitted to the cardiac care unit with profound hypotension (systolic blood pressure 70 mm Hg), cool extremities, and evidence of end-organ hypoperfusion (oliguria and rising lactate). After fluid optimization and vasopressor support provide inadequate perfusion, the cardiac team elects to insert an intra‑aortic balloon pump (IABP) percutaneously to augment diastolic coronary perfusion and reduce left ventricular afterload. The procedure is performed in the catheterization laboratory or a hybrid operating room under sterile technique with continuous hemodynamic and fluoroscopic guidance. Vascular access is obtained, commonly via the femoral artery, the 33967 IABP catheter is advanced and positioned in the descending thoracic aorta, and device function is confirmed by waveform and imaging. Post‑insertion care includes hemodynamic monitoring, anticoagulation management, vascular access site surveillance, and device removal when hemodynamics stabilize or when escalating mechanical support is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default — no modifier | Use when no other specific modifier applies to the claim |