Summary & Overview
CPT 93631: Epicardial and Endocardial Mapping and Pacing During Open Heart Surgery
CPT code 93631 denotes intraoperative epicardial and endocardial pacing and mapping performed during open heart surgery to localize tachycardia- or arrhythmia-generating foci. This procedure is clinically significant because precise localization of arrhythmogenic tissue during surgery can guide targeted ablation or resection, impacting perioperative outcomes and long-term rhythm control for patients with complex arrhythmias. Nationally, the code is relevant to hospitals, cardiothoracic surgical teams, and cardiac electrophysiology services that participate in surgical management of arrhythmias.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 93631, typical sites of service, and the kinds of documentation and service descriptors that support coding. The publication outlines common modifiers associated with intraoperative cardiac procedures and indicates where payer policy or coverage language typically applies. It also summarizes benchmarking considerations and policy updates that affect billing, coding specificity, and reimbursement pathways for complex intraoperative cardiac mapping procedures.
This material is intended for coding professionals, clinical staff involved in perioperative cardiac care, and policy analysts seeking a national-level brief on the code's clinical role, payer landscape, and documentation expectations. Data not available in the input is explicitly noted in the relevant sections of the full publication.
Billing Code Overview
CPT code 93631 describes intraoperative cardiac mapping and pacing performed on both the epicardial (outer) and endocardial (inner) surfaces of the heart to localize tachycardia- or arrhythmia-generating foci during open heart surgery. The procedure involves direct electrical mapping and temporary pacing to identify the precise sites responsible for abnormal rhythms.
Service type: Intraoperative cardiac epicardial and endocardial mapping with pacing
Typical site of service: Operating room during open cardiac surgery (inpatient or procedural suite associated with cardiothoracic surgery)
Clinical & Coding Specifications
Clinical Context
A 63-year-old male with ischemic cardiomyopathy is scheduled for open-heart surgery for coronary artery bypass grafting and concurrent evaluation of recurrent intraoperative atrial tachyarrhythmias. During the median sternotomy and cardiopulmonary bypass, the cardiac electrophysiology team performs epicardial and endocardial pacing and mapping to localize tachycardia and arrhythmogenic foci that are contributing to hemodynamically significant arrhythmias. The workflow includes preoperative review of prior electrocardiography and telemetry, intraoperative placement of epicardial pacing/sensing wires on the surface of the heart, transvenous access for endocardial mapping catheters as indicated, programmed stimulation and pacing protocols to induce and characterize arrhythmia, recording of activation sequences, and documentation of targeted sites for possible surgical ablation or modification. Post-mapping, findings are communicated to the surgical team to guide lesion placement or adjunctive therapy, and mapping data are included in the operative report and billing documentation for code 93631.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When two surgeons perform distinct portions of the open-heart operation and both are contributing to the mapping procedure. |