2025 CPT code 33535
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Surgery - Coronary Artery Bypass Grafting Surgery Feed
Coronary artery bypass using three arterial grafts.
Modifiers may be appropriate to reflect specific circumstances, such as the use of surgical assistants (modifier 80) or other circumstances outlined in the CPT manual. Consult the most current CPT guidelines for appropriate modifier usage.
Medical necessity for CABG is established based on the severity of coronary artery disease, the presence of significant symptoms (angina, heart failure), and the potential for improved survival or reduction of future cardiac events.Documentation must support the need for the procedure based on these factors.
The clinical responsibility rests with the cardiovascular surgeon performing the procedure. This includes pre-operative assessment, planning of the procedure, harvesting of the grafts, performing the anastomoses, and post-operative care.Anesthesiologist and perfusionist support may also be involved.
In simple words: The doctor performs heart bypass surgery using three arteries taken from other parts of the body. These arteries are connected to the heart's blocked arteries to restore blood flow, improving heart function and reducing chest pain.
This CPT code reports the performance of a coronary artery bypass procedure using three arterial grafts.The procedure involves harvesting arterial grafts (typically from the internal mammary arteries or radial artery), preparing the graft segments, and anastomozing them to the coronary arteries to bypass blockages.The procedure may include cardiopulmonary bypass (CPB), cardioplegia, and the use of a heart-lung machine. Procurement of the arteries is generally included unless an upper extremity artery (e.g., radial artery) is harvested, in which case additional coding is required (33509 or 35600).
Example 1: A 65-year-old male patient presents with angina and significant stenosis in the left anterior descending (LAD), circumflex, and right coronary arteries. The surgeon performs a CABG using the left internal mammary artery (LIMA) to the LAD, the right internal mammary artery (RIMA) to the circumflex, and the radial artery to the right coronary artery.This is a typical scenario for 33535., A 72-year-old female patient with multivessel CAD undergoes a CABG with the left internal mammary artery (LIMA) to the LAD, a saphenous vein graft to the obtuse marginal branch, and a radial artery to the right coronary artery.Because a venous graft is also used, an additional code from the range 33517-33523 is required, along with code 35600 to reflect the harvesting of the radial artery., A 58-year-old male patient presents with severe angina and significant stenosis in three major coronary arteries.Due to limited venous options, the surgeon decides to utilize three arterial grafts (LIMA, RIMA, and radial artery) for the CABG. Code 33535 is used, along with code 35600 for the radial artery harvest.
** Always refer to the most up-to-date CPT manual and payer-specific guidelines for accurate coding.Consider the specific details of each case to ensure appropriate code selection and modifier usage.
- Revenue Code: P2A (Major Procedure, Cardiovascular - CABG)
- RVU: The relative value units (RVUs) for this code will vary based on geographic location, facility type, and other factors. Consult the appropriate fee schedule for specific values.
- Global Days: The global period for this procedure is dependent upon the specific circumstances of the procedure and the payer involved.This information is best obtained from the payer's specific guidelines.
- Payment Status: Active
- Modifier TC rule: Technical component (TC) modifiers are not typically applicable to this code since it encompasses the entire surgical procedure.
- Fee Schedule: Historical fee schedule information is not included here. Consult relevant databases for this information.
- Specialties:Cardiovascular Surgery, Cardiac Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center