Summary & Overview
CPT 33997: Percutaneous Right Heart VAD and Venous Cannula Removal
CPT code 33997 represents the surgical removal of a percutaneous right heart ventricular assist device (VAD) and associated venous cannula during a separate operative encounter after device placement. This code is used when the VAD has achieved hemodynamic stabilization or when a patient proceeds to an artificial heart implant or heart transplantation. Nationally, accurate reporting of 33997 matters for care continuity, device lifecycle tracking, and appropriate facility and professional billing for subsequent operative management of temporary right-sided mechanical circulatory support.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical context for device removal, common settings where the service is performed, and the payer mix likely to impact coverage and administrative requirements.
Readers will learn the clinical intent and service setting for 33997, which payers are commonly relevant for the service, and what types of benchmarks and policy topics are typically associated with percutaneous right heart VAD removal (for example, coding specificity for separate operative encounters, clinical indications for removal, and payer coverage considerations). Data not available in the input is noted where applicable, and readers should consult payer policies for coverage details and claim submission rules.
Billing Code Overview
CPT code 33997 describes the removal of a percutaneous right heart ventricular assist device (VAD) and venous cannula. The procedure is performed when the VAD has supported the patient through stabilization, or when the patient undergoes implantation of an artificial heart or receives a heart transplantation. This service is rendered at a separate operative encounter following the initial placement of the percutaneous right heart VAD.
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Service type: Surgical removal of percutaneous right heart VAD and venous cannula
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Typical site of service: Operating room or procedural suite during a subsequent operative encounter
Clinical & Coding Specifications
Clinical Context
A typical patient is a critically ill adult who previously received a percutaneous right ventricular assist device (RVAD) for acute right heart failure or cardiogenic shock following myocardial infarction, post-cardiotomy failure, or right ventricular failure after left ventricular device placement. The RVAD was placed in an earlier operative encounter to stabilize hemodynamics. After clinical improvement, recovery of right ventricular function, patient stabilization, or definitive therapy such as orthotopic heart transplantation or implantation of a durable left ventricular assist device, the cardiovascular surgeon schedules a separate procedure to remove the percutaneous RVAD and venous cannula.
The clinical workflow includes preoperative evaluation in the intensive care unit with hemodynamic assessment, review of device function and coagulation status, imaging as needed to confirm cannula position, coordination with anesthesia for monitored sedation or general anesthesia, sterile removal of the cannula in the operating room or interventional suite, hemostasis and wound care, postprocedure monitoring for bleeding, arrhythmia, or recurrent right heart failure, and documentation of device removal. Billing is reported using 33997 at the distinct operative encounter when the VAD and venous cannula are removed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Provider's usual, customary, and reasonable service |