2025 CPT code 33863
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction (e.g., Bentall).
Modifiers may be applicable depending on the circumstances of the surgery.Consult the CPT manual and payer-specific guidelines for appropriate modifier use.
Medical necessity is established by the presence of a symptomatic or enlarging ascending aortic aneurysm, aortic dissection, or significant aortic valve insufficiency threatening hemodynamic stability or organ function.Preoperative imaging and assessment by a cardiologist or cardiovascular surgeon are required to justify the procedure.
The surgeon performs a sternotomy (incision through the breastbone), initiates cardiopulmonary bypass (CPB), manages hypothermia if needed, transects the aorta, removes the diseased aortic valve, selects and implants the appropriate valved conduit, meticulously dissects and reimplants the coronary arteries, and closes the incision.
In simple words: The doctor repairs a weakened part of the main artery (aorta) near the heart by replacing it with a tube-like graft that has an artificial heart valve.The blood vessels supplying blood to the heart muscle are also reconnected to the new graft. A heart-lung machine is used during the surgery.
This CPT code, 33863, describes the surgical procedure of ascending aorta grafting with cardiopulmonary bypass (CPB).It involves replacing the aortic root and proximal ascending aorta using a valved conduit, and also includes coronary artery reconstruction.The procedure necessitates the use of a cardiopulmonary bypass machine to temporarily take over the heart and lung functions, allowing for a bloodless surgical field. The coronary arteries are carefully dissected and reimplanted into the new graft.This is often referred to as a Bentall procedure.
Example 1: A 65-year-old male presents with an ascending aortic aneurysm and aortic valve insufficiency.The surgeon performs a Bentall procedure (33863) using a composite graft with a prosthetic valve.The coronary arteries are reimplanted into the graft., A 72-year-old female with a history of Marfan syndrome requires surgery for an ascending aortic dissection.The surgeon performs an ascending aortic replacement with aortic root replacement and coronary reimplantation (33863) with CPB., A 58-year-old male undergoes a re-do Bentall procedure (33863) due to graft infection one year after the initial surgery.Code +33530 is added to reflect the increased complexity of the re-operation.
Preoperative echocardiogram, CT angiogram, or other appropriate imaging to demonstrate the extent of the aortic aneurysm or dissection.Intraoperative photographs or videos documenting the surgical steps, including the coronary reimplantation and valve placement. Postoperative echocardiogram to confirm valve function and the absence of leaks.
** The description of this procedure may also include terms such as "aortic root replacement," "valved conduit," and "coronary reimplantation."Ensure all components of the procedure are accurately documented to support the use of this code.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable
- Specialties:Cardiothoracic Surgery, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center