Summary & Overview
CPT 33982: VAD Pump Replacement, Single Ventricle, No Bypass
CPT code 33982 denotes replacement of the implanted pump component of a previously placed ventricular assist device (VAD) in a single ventricle, performed without cardiopulmonary bypass. This technically complex, operative procedure is an important part of advanced mechanical circulatory support management and has implications for coding accuracy, hospital surgical workflow, and resource utilization across tertiary care centers. Nationally, correct use of this code affects procedural volume reporting and payment for high-acuity cardiac surgical services.
Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for pump-exchange procedures, expected sites of service, and coding considerations tied to VAD management. The publication provides benchmarks where available, notes recent policy and reimbursement developments affecting VAD procedural coding, and explains how 33982 relates to broader surgical and quality reporting for advanced heart-failure care.
This summary is aimed at hospital billing teams, cardiac surgeons, health policy analysts, and revenue cycle stakeholders seeking a national perspective on clinical coding, documentation priorities, and payer coverage patterns for VAD pump replacement without cardiopulmonary bypass.
Billing Code Overview
CPT code 33982 describes the surgical replacement of an implanted pump for a previously placed ventricular assist device (VAD) in a single ventricle, performed without the use of cardiopulmonary bypass.
Service type: Surgical procedure — VAD pump replacement.
Typical site of service: Hospital operating room or cardiac surgical suite for invasive cardiac surgery.
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Clinical & Coding Specifications
Clinical Context
A 58-year-old male with an existing left ventricular assist device (VAD) implanted six years prior presents with progressive device alarm signals and evidence of pump malfunction on device interrogation. The patient remains hemodynamically supported by the VAD, with no requirement for cardiopulmonary bypass. The surgical team schedules a planned operative replacement of the implanted pump component only (pump exchange) through the prior thoracotomy/sternotomy incision. Preoperative workflow includes device interrogation, chest imaging (chest radiograph and focused CT as needed), routine preoperative labs, crossmatching of blood, anesthesia evaluation, and confirmation of device model and compatible replacement pump. Intraoperative workflow includes general endotracheal anesthesia, surgical exposure of the device pocket and cannula, temporary device management per manufacturer protocol, removal of the malfunctioning pump, implantation of the new pump, securement of driveline and connections, and intraoperative device testing. Postoperative workflow includes monitoring in a cardiac ICU, device interrogation to confirm settings and flows, anticoagulation management, wound care, and discharge planning with home VAD program coordination.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Use when two surgeons work together as primary surgeons for a complex pump replacement. |