2025 CPT code 33987
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Creation of a graft conduit to facilitate arterial perfusion for ECMO/ECLS; reported in addition to the primary procedure code.
Modifiers may be applicable depending on the circumstances of the procedure. Consult the AMA CPT manual for guidance.
The medical necessity for code 33987 is established when there is a clinical indication for ECMO/ECLS, and the creation of a graft conduit is deemed necessary to ensure adequate arterial perfusion, improving the patient's chances of survival and recovery.
The physician is responsible for creating the graft conduit to facilitate arterial perfusion for ECMO/ECLS. This includes accessing the artery, creating the anastomosis, and ensuring hemostasis.
- Surgery
- Surgical Procedures on the Cardiovascular System > Extracorporeal Membrane Oxygenation or Extracorporeal Life Support Services and Procedures
In simple words: The doctor creates a special tube (graft) to help deliver blood to a machine that does the work of the heart and lungs while they recover.This code is added to the main code for the heart-lung machine procedure.
This add-on code, 33987, represents the creation of a graft channel to improve arterial perfusion for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS).The procedure involves accessing the target artery (e.g., femoral artery), clamping and incising it longitudinally, anastomosing a graft to the arterial opening in an end-to-side fashion, clamping the graft, unclamping the artery for coagulation, and finally introducing an arterial cannula into the graft for perfusion. Hemostasis is ensured, and the site is closed with layered sutures. This is reported in addition to the primary procedure code for cannula insertion (33953-33956).
Example 1: A patient requires ECMO support due to severe respiratory failure. The physician performs cannulation and determines that a graft conduit is necessary to ensure adequate arterial perfusion for ECMO. Code 33987 is reported in addition to the appropriate cannulation code., A patient with cardiogenic shock undergoes veno-arterial ECMO. During cannulation, the surgeon encounters difficulty achieving adequate arterial flow.A graft conduit is created to facilitate arterial perfusion. Code 33987 is reported in addition to the relevant cannulation and ECMO initiation codes., A pediatric patient with congenital heart disease requires ECMO support post-surgical repair.To improve arterial access, a graft is created. The surgeon reports code 33987 along with the appropriate pediatric cannulation and ECMO initiation codes.
* Operative report detailing the creation of the graft conduit.* Type of graft material used.* Location of the arterial anastomosis.* Details about achieving hemostasis and wound closure.* Preoperative and postoperative assessments of arterial perfusion.* Imaging studies (if any) used to guide the procedure.
** This code is for the creation of the graft conduit only.Other procedures related to ECMO/ECLS, such as cannulation, initiation, and management, are coded separately.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: Data not available.RVUs vary based on geographic location and other factors.
- Global Days: Not applicable. This is an add-on code.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Data not available.Fee schedules vary by payer and geographic location.
- Specialties:Cardiothoracic Surgery, Cardiovascular Surgery, Cardiac Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center