2025 CPT code 33536
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Surgery - Coronary Artery Bypass Grafting Surgery Feed
Coronary artery bypass using arterial grafts; four or more coronary arterial grafts.
Modifiers 51 (multiple procedures), 58 (staged or related procedure), 78 (unplanned return to OR), and 80 (assistant surgeon) may be applicable depending on the circumstances.
Medical necessity for CABG is established by the presence of significant coronary artery disease causing angina, myocardial ischemia, or prior myocardial infarction refractory to medical management. The procedure is medically necessary when other less invasive interventions (e.g., angioplasty) are not feasible or have failed.
The surgeon's responsibilities include pre-operative assessment, incision (e.g., median sternotomy), establishment of cardiopulmonary bypass (if necessary), arterial graft harvesting, anastomosis of grafts to coronary arteries, and closure of the incision.Post-operative care is also the surgeon's responsibility.Anesthesiologist services would be separately coded.
In simple words: This code covers heart bypass surgery where the doctor uses four or more arteries from other parts of the body to create new pathways around blocked areas in the heart's arteries, improving blood flow to the heart muscle.
This CPT code (33536) reports coronary artery bypass procedures using four or more arterial grafts.The procedure involves harvesting arterial grafts (e.g., internal mammary artery, gastroepiploic artery, epigastric artery, radial artery) and grafting them to bypass blocked coronary arteries, restoring blood flow to the heart muscle.Harvesting of the artery is typically included, except for upper extremity arteries (e.g., radial artery), which require separate coding (33509 or 35600).The use of cardiopulmonary bypass (CPB) may be necessary, depending on the surgical approach.
Example 1: A 65-year-old male presents with severe angina and significant blockage in the left anterior descending artery, circumflex artery, and right coronary artery.The surgeon performs a CABG using the left and right internal mammary arteries and two radial artery grafts., A 72-year-old female with unstable angina and multi-vessel coronary artery disease undergoes a CABG procedure. The surgical team utilizes the bilateral internal mammary arteries, a gastroepiploic artery, and a segment of radial artery as grafts., A 58-year-old male with a history of myocardial infarction and significant left main coronary artery stenosis undergoes urgent CABG surgery.The surgical team uses bilateral internal mammary artery grafts, along with two additional radial artery grafts to revascularize the affected coronary vessels.
Operative report detailing the number and type of arterial grafts used, location of harvest sites, and any additional procedures (e.g., harvesting of upper extremity arteries or veins).Pre-operative and post-operative assessments, including EKGs and cardiac enzymes.Imaging studies (e.g., coronary angiography) showing the extent of coronary artery disease.
** This code encompasses the complete surgical procedure, including harvesting and grafting of four or more arterial grafts.Appropriate selection of this code requires detailed review of the operative report.
- Revenue Code: P2A (Major Procedure, Cardiovascular - CABG)
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code as it represents the complete procedure.
- Specialties:Cardiothoracic Surgery, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center