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2025 CPT code 33533

Coronary artery bypass using a single arterial graft.

Refer to the AMA CPT® manual for the most up-to-date coding guidelines and conventions for coronary artery bypass grafting.

Modifiers may be applied based on specific circumstances, such as the use of a surgical assistant (modifier 80).Consult the AMA CPT® manual for further details.

Medical necessity for CABG is established based on the patient's symptoms (angina, dyspnea), the severity of coronary artery disease (as demonstrated by angiography), and the failure of less invasive treatment options.The selection of an arterial graft over a venous graft is typically determined by the surgeon based on the patient's individual characteristics and the anatomy of the coronary vessels.

The surgeon is responsible for all aspects of the procedure, including patient preparation, incision, arterial graft harvest, coronary artery anastomosis, cardiopulmonary bypass (if used), and wound closure.Anesthesiologists and other healthcare professionals may participate, but the surgeon holds primary responsibility.

IMPORTANT:If using multiple arterial grafts, use codes 33534-33536.If using combined arterial and venous grafts, use codes 33517-33523 in addition to the appropriate arterial graft code (33533-33536).Harvesting an upper extremity artery requires additional code 33509 or 35600. Harvesting an upper extremity vein requires additional code 35500. Harvesting a femoropopliteal vein segment requires additional code 35572.

In simple words: The doctor performs heart bypass surgery using a single artery taken from another part of the body to reroute blood around a blocked artery in the heart. This helps improve blood flow and reduce chest pain.

This CPT code reports the performance of a coronary artery bypass procedure using a single arterial graft.The procedure involves harvesting an arterial graft (typically the internal mammary artery, but could be from other sites like the gastroepiploic, epigastric, or radial artery) and anastamosing it to bypass a diseased coronary artery.Procurement of the artery is included in the code, except for upper extremity arteries (e.g., radial artery), which require separate coding (33509 or 35600).The code encompasses all aspects of the procedure, including cardiopulmonary bypass (if used), cardioplegia, and closure. If combined arterial-venous grafts are used, additional codes (33517-33523) are required, and the arterial graft must be separately coded (33533-33536).

Example 1: A 65-year-old male presents with angina and is diagnosed with significant stenosis of the left anterior descending coronary artery.A single internal mammary artery graft is used to bypass the stenosis., A 72-year-old female with history of myocardial infarction undergoes CABG surgery.A single radial artery graft is used to bypass the right coronary artery, requiring additional coding for the radial artery harvest., A 58-year-old male with multivessel coronary artery disease undergoes CABG surgery. A combined arterial and venous graft is used, requiring the reporting of both 33533 and an appropriate code from 33517-33523.

Operative report detailing the specific arterial graft used, the number of anastomoses, the use of cardiopulmonary bypass, and cardioplegia. Preoperative assessment, including coronary angiography, echocardiography, and cardiac risk assessment.Postoperative care notes, including hemodynamic monitoring and any complications.Hospital discharge summary including the outcome of the procedure and any recommendations.

** Always refer to the most current CPT® codebook and payer guidelines for the most accurate coding information.This information is for guidance only and should not be considered definitive legal or medical advice.The use of cardiopulmonary bypass is not always required and does not affect the code selection.

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