2025 CPT code 33321
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Cardiovascular System Feed
Suture repair of aorta or great vessels; with shunt bypass.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 51 for multiple procedures, 59 for distinct procedural services, 78 for unplanned return to the OR).
Medical necessity is established by the presence of a significant injury or defect in the aorta or great vessels requiring surgical repair to prevent life-threatening complications (e.g., hemorrhage, aortic dissection, or cardiac tamponade).
The surgeon is responsible for all aspects of the procedure, including pre-operative planning, incision, shunt placement, vessel repair, shunt removal, closure of the incision, and post-operative care.Anesthesiologist provides anesthesia.
In simple words: The doctor repairs a tear or damage in the large blood vessels near the heart using stitches.To do this safely, they use a small tube to temporarily reroute blood flow around the damaged area.
This procedure involves the surgical repair of the aorta or other great vessels of the heart using sutures. A shunt bypass is utilized to temporarily redirect blood flow, allowing for the safe repair of the damaged vessel.The surgeon makes an incision (sternotomy or thoracotomy), inserts a shunt to bypass the affected area, repairs the vessel using sutures, removes the shunt, and closes the incision.A chest tube or drainage tube may be left in place.
Example 1: A patient presents after a motor vehicle accident with a laceration of the ascending aorta. The surgeon performs an emergency sternotomy, places a shunt to divert blood flow, repairs the aorta using sutures, removes the shunt, and closes the incision., A patient with a penetrating chest wound sustaining damage to the aortic arch undergoes repair with a shunt bypass. The surgeon performs a thoracotomy, inserts a shunt, repairs the aorta, removes the shunt, and closes the chest., During a cardiac catheterization, iatrogenic injury to the pulmonary artery occurs.A cardiothoracic surgeon is called to repair the injury using a shunt bypass.The surgeon uses a minimally invasive approach to insert the shunt and place sutures to repair the artery.
Pre-operative assessment including imaging (e.g., CT scan, aortogram), operative report detailing the approach (sternotomy or thoracotomy), type of shunt used, description of the repair, and post-operative course.Pathology report if tissue is sent.
** This code should only be used when a shunt bypass is employed. If cardiopulmonary bypass is used, code 33322 should be used instead.The choice between 33320, 33321, and 33322 depends on whether a bypass (shunt or cardiopulmonary) was used.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Cardiothoracic Surgery, Vascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center