2025 CPT code 33405
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on Cardiac Valves Surgical Procedures on the Cardiovascular System Feed
Open surgical replacement of the aortic valve using cardiopulmonary bypass with a prosthetic valve (excluding homograft or stentless valve).
Modifiers may be applicable depending on the specific circumstances of the procedure.Consult the CPT® manual for modifier guidelines.
Medical necessity is established by documented symptoms of aortic stenosis or regurgitation, confirmed by echocardiogram, cardiac catheterization, or other appropriate diagnostic studies.The severity of the valve disease must warrant surgical intervention.
The clinical responsibility lies with the cardiac surgeon performing the open-heart surgery.This includes pre-operative assessment, surgical procedure, and post-operative care.
- Surgical Procedures on the Cardiovascular System
- Surgical Procedures on the Cardiovascular System > Surgical Procedures on the Heart and Pericardium > Surgical Procedures on Cardiac Valves > Surgical Procedures on the Aortic Valve
In simple words: The surgeon replaces a faulty heart valve (aortic valve) with a man-made one. This requires open-heart surgery and a heart-lung machine to keep blood flowing and oxygen levels normal during the operation. After surgery, a test is done to check the new valve's function.
This procedure involves replacing a diseased or damaged aortic valve with a prosthetic valve.The procedure is performed via an open surgical approach, requiring a sternotomy and cardiopulmonary bypass (CPB) to maintain blood flow and oxygenation during the surgery.The diseased aortic valve is removed, and a prosthetic valve is implanted.Post-operative echocardiogram is performed to assess valve function.The specific type of prosthetic valve used should be documented.
Example 1: A 70-year-old patient with severe aortic stenosis undergoes open-heart surgery with CPB for aortic valve replacement using a bioprosthetic valve.Code 33405 is reported., A 65-year-old patient with bicuspid aortic valve and significant aortic regurgitation undergoes open-heart surgery with CPB.A prosthetic valve is used for replacement. Code 33405 is reported., A 55-year-old patient with a history of rheumatic heart disease resulting in a severely stenotic aortic valve. Open-heart surgery is performed with CPB, and a mechanical prosthetic valve is implanted. Code 33405 is reported.
Operative report detailing the surgical approach (sternotomy), use of cardiopulmonary bypass, removal of the native aortic valve, type of prosthetic valve implanted, and post-operative assessment (echocardiogram).
** Always verify the type of prosthetic valve used (bioprosthetic, mechanical, etc.) to ensure accurate coding.This information should be clearly documented in the medical record.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: Work RVUs: 41.32; Total RVUs: 66.76 (2024 data; values may vary based on payer and geographic location)
- Global Days: The global surgical period is not explicitly defined for this code but should be determined based on payer guidelines and local practice standards.
- Payment Status: Active
- Modifier TC rule: No TC modifier applies to this code, as it represents the complete procedure.
- Fee Schedule: The historical fee schedule for this code is not available in the provided sources.Consult payer-specific fee schedules for historical data.
- Specialties:Cardiothoracic Surgery
- Place of Service:Inpatient Hospital