2025 CPT code 33362
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve, using an open femoral artery approach.
Modifiers applicable as per documentation requiremnts and coding guidelines.
Medical necessity must be established for TAVR based on the patient's symptomatic severe aortic stenosis, elevated risk for conventional surgery, or other clinical factors. Documentation supporting the medical necessity should be included in the patient's record.
The physician is responsible for the entire procedure, including patient preparation, anesthesia, surgical access to the femoral artery, insertion and placement of the prosthetic valve, imaging guidance, and post-operative care.
In simple words: This procedure involves replacing a diseased aortic valve with a new one through a small incision in the groin.The doctor inserts a catheter into the femoral artery and guides it to the heart to deliver the new valve.This approach is less invasive than open-heart surgery.
This code describes a transcatheter aortic valve replacement (TAVR/TAVI) procedure where a prosthetic valve is implanted via an open incision into the femoral artery. This approach involves surgically exposing the femoral artery in the groin to insert the delivery catheter system for the valve.The procedure includes percutaneous access, placement of the access sheath, balloon aortic valvuloplasty (if performed), advancing and positioning the valve delivery system, deploying the valve, temporary pacemaker insertion for rapid pacing (if performed), and closure of the arteriotomy.
Example 1: A 78-year-old patient with severe aortic stenosis and multiple comorbidities is considered high-risk for traditional open-heart surgery. TAVR via the open femoral artery approach is chosen as a less invasive alternative., A patient with a previous femoral artery bypass graft requires TAVR.The open femoral artery approach is used to ensure adequate access and minimize the risk of complications., A patient undergoing TAVR experiences complications during the procedure, requiring conversion to an open approach. The already exposed femoral artery facilitates this transition and allows for additional surgical interventions if necessary.
Documentation should include pre-operative imaging results, patient selection criteria (justifying the need for TAVR and open approach), operative report detailing the procedure including access method, valve type/size, intraoperative complications (if any), fluoroscopy time, and post-operative progress notes.
** This code describes a specific approach for TAVR. It's crucial to select the correct code based on the access method used (femoral, axillary, transaortic, etc.) and whether cardiopulmonary bypass support is required.Always refer to the most recent CPT coding guidelines and regulations for accurate coding and reimbursement.
- Revenue Code: 278
- RVU: 24.54 (Work RVU), Facility Rate: $790 (as of 2024), Non-Facility Rate : $1264 (as of 2024)
- Global Days: Global Days: Refer to iFrameAI for up-to-date information.
- Payment Status: Active
- Modifier TC rule: Refer to iFrameAI for current TC modifier rules. Modifier 62 if the service requires two surgeons.
- Fee Schedule: Refer to CMS or other fee schedule databases for historical payment information.
- Specialties:Cardiology, Cardiothoracic Surgery, Interventional Radiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center