2025 CPT code 33864
(Active) Effective Date: N/A Revision Date: N/A Surgery - Aortic Procedures Cardiovascular System Feed
Ascending aorta graft, with cardiopulmonary bypass, valve suspension, coronary reconstruction, and valve-sparing aortic root remodeling (e.g., David or Yacoub Procedure).
Modifiers may be applicable based on specific circumstances (e.g., 59 for distinct procedural services, 22 for increased procedural services, 58 for staged procedures, etc.).Consult the most recent CPT modifier guidelines.
The procedure is medically necessary for patients with symptomatic or asymptomatic ascending aortic aneurysms and/or aortic root dilation that meet specific criteria. The procedure aims to prevent life-threatening complications such as aortic rupture or dissection while preserving native valve function whenever possible.
The cardiac surgeon is responsible for all aspects of the surgery, including pre-operative assessment, cardiopulmonary bypass management, aortic root reconstruction, coronary artery reimplantation, valve repair/remodeling, and post-operative care.
In simple words: The surgeon repairs a weakened part of the main artery leading from the heart (aorta) using a synthetic tube graft.The heart's own valve is kept and repaired; the heart and lungs are temporarily bypassed using a machine during surgery.
This procedure involves replacing the ascending aorta and aortic root with a graft while preserving the patient's native aortic valve.Cardiopulmonary bypass is utilized. The coronary arteries are reconstructed and reimplanted into the graft. The aortic valve is suspended and remodeled, maintaining its function. This technique is often referred to as the David or Yacoub procedure, depending on the specific surgical approach used.
Example 1: A 65-year-old male presents with an ascending aortic aneurysm and aortic root dilation.The patient undergoes a valve-sparing aortic root replacement (David procedure) with coronary reimplantation., A 70-year-old female with bicuspid aortic valve and significant aortic root dilation requires valve-sparing root replacement (Yacoub technique). Cardiopulmonary bypass is used during the operation, involving coronary artery reconstruction., A 58-year-old patient presents with a bicuspid aortic valve and significant ascending aortic aneurysm. He undergoes a complex valve-sparing aortic root replacement utilizing both David and Yacoub surgical techniques.
** This procedure is highly complex, requiring advanced surgical expertise and specialized equipment.The selection of 33863 or 33864 depends on the specifics of the aortic root reconstruction and valve-sparing techniques used.
- Revenue Code: P2B (Major Procedure, Cardiovascular - Aneurysm Repair)
- RVU: This requires consultation with the current year's Medicare Physician Fee Schedule for RVUs and conversion factors.RVUs vary based on geographic location and other factors.
- Global Days: The global period for this procedure is typically 90 days post-operative. Refer to payer-specific guidelines for definitive information.
- Payment Status: Active
- Modifier TC rule: This code is unlikely to require a TC (technical component) modifier, as the entirety of the procedure is considered one surgical service.
- Fee Schedule: Historical fee schedules are not directly available within this response. Fee data is subject to change depending on insurance payers, geographic location, and other variables. Consult appropriate fee schedules to determine historical payment rates.
- Specialties:Cardiothoracic Surgery
- Place of Service:Inpatient Hospital