2025 CPT code 33523
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Surgery - Coronary artery bypass grafting Surgery Feed
Coronary artery bypass using venous and arterial grafts; 6 or more venous grafts.
Modifier 80 (assistant surgeon) may be added to 33523 and the arterial graft code if an assistant surgeon performed the graft procurement.
Medical necessity is established based on the patient's symptoms (e.g., angina), the severity of coronary artery disease, and the assessment that revascularization is necessary to improve myocardial perfusion and reduce the risk of future cardiac events.Documentation should include evidence of significant coronary artery disease that warrants surgical intervention.
The surgeon's responsibilities include harvesting the venous grafts (typically from the saphenous vein), preparing the grafts, anastomosing the distal ends to the diseased coronary arteries, and anastomosing the proximal ends to the aorta.The surgeon also performs the arterial grafting as part of the overall coronary artery bypass procedure.Post-operative care and monitoring are also included in the global surgical package.
In simple words: This code describes a heart surgery where the doctor uses veins from another part of the body (like the leg) and arteries to create new pathways for blood flow around blocked areas in the heart.This specific code is for when six or more veins are used. This procedure helps improve blood flow to the heart.
This CPT code, 33523, reports coronary artery bypass procedures involving both venous and arterial grafts, specifically when six or more venous grafts are used.The procurement of the saphenous vein graft is included and should not be billed separately.This code is always used in conjunction with an arterial graft code (33533-33536) and cannot stand alone.If an upper extremity artery is used, additional codes for harvesting (33509 or 35600) may be necessary.For upper extremity vein harvesting, use 35500. Femoropopliteal vein segment harvesting requires code 35572.
Example 1: A 65-year-old male patient presents with severe angina and is diagnosed with significant multi-vessel coronary artery disease.The cardiothoracic surgeon performs a CABG using seven saphenous vein grafts and two internal mammary artery grafts.Code 33523 is reported with the appropriate arterial graft codes., A 72-year-old female patient undergoes a CABG procedure. The surgeon uses six saphenous vein grafts and one radial artery graft.Code 33523 is reported with the appropriate arterial graft code and code 33509 (or 35600) is also reported for the radial artery harvest., A 58-year-old male patient with critical coronary artery disease requires CABG. The surgical team uses six saphenous vein grafts and one internal mammary artery graft.The surgeon chooses to harvest a segment of femoropopliteal vein to supplement the saphenous vein grafts. Code 33523 is reported along with the appropriate arterial graft code and code 35572 for the femoropopliteal vein harvest.
The operative report should clearly specify the number of venous and arterial grafts used, the type of arterial conduit used (e.g., internal mammary artery, radial artery), and any additional procedures performed, such as harvesting of upper extremity arteries or veins, or harvesting of femoropopliteal vein segments.Preoperative diagnostic studies (coronary angiography, cardiac catheterization) should also be documented.
** Always refer to the most current CPT codebook and guidelines for accurate coding practices.The information provided here is for guidance only and does not substitute for professional coding advice.
- Revenue Code: P2A (Major Procedure, Cardiovascular - CABG)
- Payment Status: Active
- Modifier TC rule: Not applicable for 33523.
- Specialties:Cardiothoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center