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2025 CPT code 33510

Coronary artery bypass, vein only; single coronary venous graft.

See CPT guidelines for coronary artery bypass grafting procedures.Specifically, note the guidelines regarding the use of venous grafts only, and the separate reporting requirements for harvesting additional veins.

Modifiers may apply depending on the circumstances.Examples include modifier 80 (assistant surgeon) if a surgical assistant procures the graft, and modifiers 51 (multiple procedures) or 59 (distinct procedural service) if additional procedures are performed.

Medical necessity is established through documentation of significant coronary artery disease causing symptoms such as angina or myocardial ischemia, confirmed by appropriate diagnostic testing (such as coronary angiography).

The surgeon harvests the vein graft, performs the sternotomy, establishes cardiopulmonary bypass, injects cardioplegia, performs the anastomosis of the graft to the aorta and diseased coronary artery, weans the patient from bypass, and closes the incision.Anesthesiology and other supporting roles are also involved.

IMPORTANT:33517-33523 and 33533-33536 (combined arterial-venous grafts); 35500 (harvesting of an upper extremity vein); 35572 (harvesting of a femoropopliteal vein segment)

In simple words: This surgery redirects blood flow around a blocked heart artery using a vein graft from the leg. This improves blood flow to the heart, reducing chest pain (angina).

The provider diverts blood flow from a damaged vessel in the heart by grafting in a segment of a vein taken from another location, such as the leg, to restore circulation, improve the function of the heart, and decrease symptoms like angina.The procedure involves harvesting a suitable vein (typically the saphenous vein), performing a midline sternotomy, establishing cardiopulmonary bypass, injecting cardioplegia solution to stop the heart, attaching the distal end of the vein graft to the diseased vessel and the proximal end to the ascending aorta, weaning the patient off the bypass pump, irrigating, checking for bleeding, and closing the incision.

Example 1: A 65-year-old male presents with angina.Coronary angiography reveals a significant blockage in the left anterior descending artery. A single venous graft CABG using 33510 is performed., A 70-year-old female with unstable angina undergoes a single-vessel coronary artery bypass grafting procedure using a saphenous vein graft. Code 33510 is used., A patient with a history of coronary artery disease undergoes a single coronary artery bypass using a saphenous vein graft harvested from the leg.The procedure is performed on-pump (using cardiopulmonary bypass). Code 33510 is appropriate.

Operative report detailing the procedure (including type and number of grafts, use of cardiopulmonary bypass), pre-operative assessment (including coronary angiography results and patient history), and post-operative recovery notes.

** Procurement of the saphenous vein graft is included in the code.Additional codes should be used for harvesting veins from other locations (35500, 35572).

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