2025 CPT code 33534
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Surgery - Coronary Artery Bypass Grafting Surgery Feed
Coronary artery bypass using two arterial grafts.
Modifiers such as 59 (distinct procedural service) or 78 (unplanned return to the OR) may be applicable in certain situations. Modifier 80 (assistant surgeon) is used if a surgical assistant performs graft procurement.
Medical necessity for CABG is established through documentation of significant coronary artery disease causing symptoms (such as angina) or evidence of myocardial ischemia. The decision to use arterial grafts may be based on patient factors (such as age and life expectancy) and the surgeon's judgment.
The surgeon is responsible for all aspects of the procedure, including patient preparation, establishing cardiopulmonary bypass (if needed), harvesting the arterial grafts, performing the anastomoses, weaning the patient from bypass, and wound closure.
In simple words: The doctor performs heart bypass surgery using two arteries from another part of the body to reroute blood around blocked areas in the heart's arteries. This improves blood flow to the heart muscle.
This CPT code, 33534, reports the performance of a coronary artery bypass procedure utilizing two arterial grafts.The procedure involves harvesting arterial grafts (typically from the internal mammary arteries, radial arteries, or other suitable arteries), and anastomosing them to bypass occluded coronary arteries, restoring blood flow to the heart muscle.The harvesting of the arteries is included in the code unless an upper extremity artery is used; in that case, 33509 or 35600 is additionally reported. Cardiopulmonary bypass may be utilized.
Example 1: A 65-year-old male presents with angina and significant stenosis in the left anterior descending (LAD), circumflex, and right coronary arteries. The surgeon performs a CABG using the left internal mammary artery (LIMA) to the LAD, the right internal mammary artery (RIMA) to the circumflex, and a saphenous vein graft to the right coronary artery., A 72-year-old female with three-vessel disease undergoes CABG.The surgeon uses both internal mammary arteries as arterial grafts and chooses to add a radial artery graft.The patient’s vein is not used due to poor quality., A 58-year-old male with multivessel disease undergoes off-pump CABG. The surgeon uses both internal mammary arteries for grafting.Due to the off-pump nature, no cardiopulmonary bypass is used.
Operative report detailing the grafts used, including their origin and location of anastomosis. Preoperative cardiac catheterization results, including coronary angiography.Anesthesia records.Hospital course notes and discharge summary.Pathology reports (if any biopsies were performed).
** The specific arterial grafts used should be documented in the operative report.Variations in technique and the use of additional procedures may influence coding and reimbursement. Always refer to the most up-to-date coding guidelines and payer-specific policies.
- Revenue Code: P2A (Major Procedure, Cardiovascular - CABG)
- RVU: Information regarding RVUs varies based on geographic location, payer, and other factors.Consult the appropriate fee schedules for specific details.
- Global Days: The global period for this procedure is dependent on the specific circumstances and may vary based on payer and other factors.Refer to payer guidelines.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier would not typically apply to this code, as it represents the entire procedure.
- Fee Schedule: Fee schedules vary by location and payer.Consult relevant fee schedules for historical data.
- Specialties:Cardiothoracic Surgery, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center