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BETA v.3.0

2025 CPT code 33509

Endoscopic harvest of an upper extremity artery segment for coronary artery bypass.

Modifiers may be applicable. Modifier 50 is used for bilateral procedures. Other modifiers, such as 52 (reduced services), 53 (discontinued procedure), or modifiers related to specific circumstances, might be appropriate depending on the case.

Medical necessity for code 33509 is established by the need for a coronary artery bypass graft procedure. The endoscopic harvest of the upper extremity artery is a necessary component of the CABG, providing the conduit for bypassing the blocked coronary artery. Documentation should support the medical necessity of the CABG procedure itself.

The physician performs the endoscopic harvest of the artery, including making incisions, using endoscopic tools, dividing the artery, ligating the end, and closing the incisions. The harvested artery is then prepared for the coronary artery bypass procedure, which is billed separately.

IMPORTANT:For open harvest of upper extremity artery, use 35600. For bilateral procedure, report 33509 with modifier 50.

In simple words: The doctor uses a tiny camera and small tools inserted through small cuts in your arm to remove a piece of a healthy artery. This artery piece is then used to create a detour around a blocked artery in your heart.

Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic. This includes the endoscopic approach to obtain a portion of a healthy artery from the patient’s arm for use in a coronary artery bypass procedure.

Example 1: A patient with coronary artery disease requires a coronary artery bypass graft (CABG). The surgeon performs an endoscopic harvest of the radial artery from the patient's arm to use as a graft., A patient needs a CABG, and the surgeon decides to use the ulnar artery from the arm as a conduit for the bypass. The artery is harvested endoscopically., During a CABG procedure, it's determined that an additional graft is needed. Endoscopic harvest of an upper extremity artery is performed to obtain the extra graft material.

Documentation should include details of the endoscopic harvest procedure, including the specific artery harvested, the location of incisions, and any complications encountered. The medical necessity for the CABG procedure should also be documented, including the diagnosis, symptoms, and treatment options considered.

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