2025 CPT code 33364
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach.
Modifiers 22 (Increased Procedural Services), 51 (Multiple Procedures), 59 (Distinct Procedural Service), and 62 (Two Surgeons) are commonly used with code 33364. Other modifiers may be applicable depending on the specific circumstances of the procedure. Consult official modifier guidelines.
Medical necessity for TAVR is determined by the presence of symptomatic severe aortic stenosis in patients deemed to be at high risk for open-heart surgery.Documentation must support the severity of the stenosis, patient's symptoms, and the assessment of surgical risk.
The clinical responsibility rests primarily with the interventional cardiologist who performs the procedure.This includes pre-operative planning, performing the TAVR/TAVI procedure, post-operative care and follow-up.Anesthesiologist and other medical personnel (surgical team) may also be involved, depending on the specific needs of the patient.
In simple words: This code describes a heart surgery to replace a damaged aortic valve without opening the chest. A doctor inserts a new valve through a small cut in the leg artery (in the groin) using a thin tube.This procedure usually requires two doctors.
This CPT code 33364 represents transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI) using a prosthetic valve via an open iliac artery approach.The procedure involves percutaneous access, sheath placement, balloon aortic valvuloplasty (if needed), advancement and positioning of the valve delivery system, valve deployment, temporary pacemaker insertion (33210, if performed), and arteriotomy closure.Angiography, radiological supervision, and interpretation for guiding valve placement, documenting intervention completion, and assessing vascular access site closure are included.Modifier 62 is required due to the involvement of two physician operators.Add-on codes may apply for cerebral embolic protection (33370), percutaneous/open peripheral bypass (33367, 33368), or central bypass (33369), and other cardiac catheterization services performed for diagnostic purposes not intrinsic to TAVR/TAVI may be separately reported.
Example 1: A 78-year-old female with severe aortic stenosis and high surgical risk undergoes TAVR via an open iliac artery approach.The procedure is successful, and the patient recovers well.Modifier 62 is used because two surgeons performed the procedure., An 85-year-old male with symptomatic aortic stenosis and severe comorbidities undergoes TAVR. Cerebral embolic protection (code 33370) is utilized due to increased stroke risk. This is billed separately., A 72-year-old female with severe aortic stenosis requires cardiopulmonary bypass during the TAVR procedure. The appropriate add-on code for central bypass is used in conjunction with code 33364.
Detailed medical history, physical exam findings, imaging studies (echocardiogram, CT scan, etc.), informed consent, operative report detailing the approach and devices used,pathology report if applicable, post-operative care plan, and any complications encountered during or after the procedure are all essential for accurate coding.
** Always cross-reference the CPT guidelines and payer-specific rules before billing.The use of this code is restricted to procedures involving an open iliac artery approach.Accurate documentation is crucial for appropriate reimbursement.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: RVUs are not provided in the source but are dependent on several factors including geographic location and facility type. Consult the appropriate Relative Value Unit database for the most up-to-date information.
- Global Days: Global surgical period information is not available in the provided source data.Consult the official CPT guidelines or your payer's specific guidelines for this information.The global surgical period will vary depending on the complexity of the procedure and other factors.
- Payment Status: Active
- Modifier TC rule: The modifier TC (Technical Component) is not directly applicable to this code, as it is considered a complete procedure. However, depending on the circumstances other modifiers may be applicable. Consult the official modifier guidelines.
- Fee Schedule: Historical fee schedule data is not provided in the source. Consult your payer's fee schedule for details.
- Specialties:Cardiovascular Surgery, Interventional Cardiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center,On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital