Summary & Overview
CPT 33971: Intra–Aortic Balloon Removal with Femoral Artery Repair
CPT code 33971 covers surgical removal of a previously placed intra–aortic balloon from the aorta with concurrent repair of the femoral artery, potentially using a graft. This code is used when a patient has stabilized after intra–aortic balloon support and the device is explanted; placement of the intra–aortic balloon is reported separately. Nationally, this procedure is relevant for acute cardiac care pathways, postoperative vascular management, and hospital billing for advanced mechanical circulatory support.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of clinical context and typical sites of service, along with coverage and coding considerations relevant to hospital and cardiac surgery billing workflows. The publication outlines standard use cases for the code, common modifiers reported with surgical procedures, and the relationship between device placement and removal as separately billable events.
The analysis provides operational benchmarks and policy context useful for revenue cycle, clinical coding, and surgical teams, and flags areas where local payer policies or documentation requirements commonly affect claims for device explantation and femoral artery repair. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 33971 describes the surgical removal of a previously inserted intra–aortic balloon from the aorta with repair of the femoral artery, which may include use of a graft. The procedure is performed once the patient stabilizes following initial support with the intra–aortic balloon. The initial placement of the intra–aortic balloon catheter is a separately reportable procedure.
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Service type: Surgical vascular procedure for device removal and arterial repair
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Typical site of service: Operating room, cardiac surgery suite, or other inpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a critically ill adult who previously underwent insertion of an intra‑aortic balloon pump (IABP) via a femoral arterial approach for cardiogenic shock, refractory ischemia, or hemodynamic support around high‑risk cardiac surgery or percutaneous coronary intervention. Once hemodynamic stability is achieved and the IABP is no longer needed, the patient is returned to the operating room or to a monitored procedure area. The provider performs removal of the IABP catheter, assesses the femoral arterial access site, repairs the femoral artery as needed (primary repair or patch/graft), achieves hemostasis, and closes the wound. Typical workflow includes pre‑procedure assessment of anticoagulation status and vascular imaging as indicated, preparation of sterile field and vascular instruments, removal of the catheter under controlled conditions, arterial repair or graft placement if there is significant arterial injury, and post‑procedure monitoring for bleeding, limb perfusion, and hemodynamic stability. Usual sites of service are the operating room or interventional/procedure suite, and recovery occurs in the intensive care unit or step‑down unit.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal/standard service | When the procedure is performed as scheduled without unusual circumstances. |