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The CPT® Code 33257 refers to the operative tissue ablation and reconstruction of the atria, specifically performed during another cardiac procedure. This limited approach, often described as a modified maze procedure, is utilized to address chronic atrial fibrillation, a condition characterized by rapid and uncoordinated contractions of the upper chambers of the heart, leading to an irregular and often rapid heartbeat. The maze procedure is designed to create new electrical pathways within the heart, effectively interrupting the abnormal conduction pathways that contribute to atrial fibrillation. By making precise incisions in the atrial tissue, the surgeon establishes ablation lines that facilitate the normal flow of electrical impulses from the sinoatrial node to the atrioventricular node, thereby restoring the atria to a state of normal contraction and size. This procedure can be performed on either the left atrium or both atria, depending on the patient's specific needs. The surgical technique may involve various methods, including cryoablation or radiofrequency ablation, which can simplify the process by creating lesions without the need for extensive suturing. Additionally, the modified maze procedure may include strategies to preserve the sinus node artery and may involve electrophysiological exclusion of the atrial appendage rather than its complete anatomical removal. This code is reported separately in conjunction with the primary cardiac procedure being performed, highlighting its role as an adjunctive treatment in the management of atrial fibrillation.
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The modified maze procedure, represented by CPT® Code 33257, is indicated for patients suffering from chronic atrial fibrillation. This condition is characterized by rapid and uncoordinated contractions of the atria, leading to an irregular and often accelerated heartbeat. The procedure is typically performed in conjunction with other cardiac surgeries, making it essential for patients who require additional interventions to restore normal heart rhythm and function.
The modified maze procedure involves several critical steps aimed at correcting atrial fibrillation through operative tissue ablation and reconstruction of the atria. The procedure begins with the surgeon making an incision through the interatrial groove, which allows access to the atrial chambers. Following this, the atrial appendage may be excised to facilitate the procedure. The surgeon then proceeds to make precise atrial incisions, which are essential for creating ablation lines. These lines serve to interrupt the conduction of abnormal electrical impulses that contribute to atrial fibrillation. By establishing these new pathways, the procedure aims to restore normal electrical conduction from the sinoatrial node to the atrioventricular node, ultimately leading to normal atrial contractions and size. Depending on the patient's condition, the maze procedure may be performed on the left atrium alone or on both atria. After the necessary incisions and ablations are completed, the incision sites are sutured to ensure proper healing. The modified maze procedure may also incorporate techniques such as altered atriotomies to avoid disrupting the sinus node artery, and the use of cryo- or radiofrequency ablation to create tissue lesions or ablation lines, simplifying the procedure and minimizing the need for extensive suturing.
After the modified maze procedure, patients typically require careful monitoring to assess their recovery and the effectiveness of the intervention. Post-procedure care may include managing any discomfort or pain at the incision sites, monitoring heart rhythm, and ensuring that the patient is stable. The expected recovery period can vary based on the individual patient's health status and the complexity of the procedure performed alongside the maze procedure. Patients may need to follow specific guidelines regarding activity levels and follow-up appointments to ensure proper healing and to evaluate the success of the procedure in restoring normal heart rhythm. Additional considerations may include medication management to prevent thromboembolic events and to support overall cardiac health during the recovery phase.
| Short Descr | ABLATE ATRIA LMTD ADD-ON | Medium Descr | ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE | Long Descr | Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2B - Major procedure, cardiovascular-Aneurysm repair | MUE | 1 | CCS Clinical Classification | 49 - Other OR heart procedures |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 33120 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Excision of intracardiac tumor, resection with cardiopulmonary bypass | 33130 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Resection of external cardiac tumor | 33250 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass | 33251 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass | 33261 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass | 33300 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Repair of cardiac wound; without bypass | 33305 | MPFS Status: Active Code APC C Physician Quality Reporting Repair of cardiac wound; with cardiopulmonary bypass | 33310 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass | 33315 | MPFS Status: Active Code APC C Physician Quality Reporting Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass | 33320 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass | 33321 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Suture repair of aorta or great vessels; with shunt bypass | 33322 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Suture repair of aorta or great vessels; with cardiopulmonary bypass | 33330 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass | 33335 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Insertion of graft, aorta or great vessels; with cardiopulmonary bypass | 33365 | MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy) | 33390 | MPFS Status: Active Code APC C Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural resuspension) | 33391 | MPFS Status: Active Code APC C Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty) | 33404 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Construction of apical-aortic conduit | 33405 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve | 33406 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand) | 33410 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve | 33411 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus | 33412 | MPFS Status: Active Code APC C Illustration for Code Replacement, aortic valve; with transventricular aortic annulus enlargement (Konno procedure) | 33413 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (Ross procedure) | 33414 | MPFS Status: Active Code APC C Illustration for Code Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract | 33415 | MPFS Status: Active Code APC C Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis | 33416 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy) | 33417 | MPFS Status: Active Code APC C Illustration for Code Aortoplasty (gusset) for supravalvular stenosis | 33420 | MPFS Status: Active Code APC C Illustration for Code Valvotomy, mitral valve; closed heart | 33422 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Valvotomy, mitral valve; open heart, with cardiopulmonary bypass | 33425 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Valvuloplasty, mitral valve, with cardiopulmonary bypass; | 33426 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring | 33427 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring | 33430 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Replacement, mitral valve, with cardiopulmonary bypass | 33440 | Resequenced Code MPFS Status: Active Code APC C Replacement, aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (Ross-Konno procedure) | 33460 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Valvectomy, tricuspid valve, with cardiopulmonary bypass | 33463 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Valvuloplasty, tricuspid valve; without ring insertion | 33464 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Valvuloplasty, tricuspid valve; with ring insertion | 33465 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Replacement, tricuspid valve, with cardiopulmonary bypass | 33468 | MPFS Status: Active Code APC C Tricuspid valve repositioning and plication for Ebstein anomaly | 33474 | MPFS Status: Active Code APC C Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass | 33475 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Replacement, pulmonary valve | 33476 | MPFS Status: Active Code APC C Illustration for Code Right ventricular resection for infundibular stenosis, with or without commissurotomy | 33478 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection | 33496 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure) | 33500 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass | 33501 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass | 33502 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of anomalous coronary artery from pulmonary artery origin; by ligation | 33503 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass | 33504 | MPFS Status: Active Code APC C Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass | 33505 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (Takeuchi procedure) | 33506 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Repair of anomalous coronary artery from pulmonary artery origin; by translocation from pulmonary artery to aorta | 33507 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation | 33510 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; single coronary venous graft | 33511 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 2 coronary venous grafts | 33512 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 3 coronary venous grafts | 33513 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 4 coronary venous grafts | 33514 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Coronary artery bypass, vein only; 5 coronary venous grafts | 33516 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 6 or more coronary venous grafts | 33533 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Coronary artery bypass, using arterial graft(s); single arterial graft | 33534 | MPFS Status: Active Code APC C Physician Quality Reporting Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts | 33535 | MPFS Status: Active Code APC C Physician Quality Reporting Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts | 33536 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts | 33542 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Myocardial resection (eg, ventricular aneurysmectomy) | 33545 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Repair of postinfarction ventricular septal defect, with or without myocardial resection | 33548 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, SVR, SAVER, Dor procedures) | 33600 | MPFS Status: Active Code APC C CPT Assistant Article Closure of atrioventricular valve (mitral or tricuspid) by suture or patch | 33602 | MPFS Status: Active Code APC C Illustration for Code Closure of semilunar valve (aortic or pulmonary) by suture or patch | 33606 | MPFS Status: Active Code APC C Illustration for Code Anastomosis of pulmonary artery to aorta (Damus-Kaye-Stansel procedure) | 33608 | MPFS Status: Active Code APC C Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery | 33610 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect | 33611 | Modifier 63 Exempt MPFS Status: Active Code APC C Repair of double outlet right ventricle with intraventricular tunnel repair; | 33612 | MPFS Status: Active Code APC C Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction | 33615 | MPFS Status: Active Code APC C Illustration for Code Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple Fontan procedure) | 33617 | MPFS Status: Active Code APC C Illustration for Code Repair of complex cardiac anomalies (eg, single ventricle) by modified Fontan procedure | 33619 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, Norwood procedure) | 33641 | MPFS Status: Active Code APC C Illustration for Code Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch | 33645 | MPFS Status: Active Code APC C Illustration for Code Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage | 33647 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Repair of atrial septal defect and ventricular septal defect, with direct or patch closure | 33660 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect), with or without atrioventricular valve repair | 33665 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair | 33670 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Repair of complete atrioventricular canal, with or without prosthetic valve | 33675 | MPFS Status: Active Code APC C Illustration for Code Closure of multiple ventricular septal defects; | 33676 | MPFS Status: Active Code APC C Illustration for Code Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic) | 33677 | MPFS Status: Active Code APC C Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset | 33681 | Changed Code for 2025 MPFS Status: Active Code APC C Illustration for Code Closure of single ventricular septal defect, with or without patch; | 33684 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic) | 33688 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset | 33690 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Banding of pulmonary artery | 33692 | Changed Code for 2025 MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Complete repair tetralogy of Fallot without pulmonary atresia; | 33694 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Complete repair tetralogy of Fallot without pulmonary atresia; with transannular patch | 33697 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Complete repair tetralogy of Fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect | 33702 | MPFS Status: Active Code APC C Illustration for Code Repair sinus of Valsalva fistula, with cardiopulmonary bypass; | 33710 | MPFS Status: Active Code APC C Illustration for Code Repair sinus of Valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect | 33720 | MPFS Status: Active Code APC C Illustration for Code Repair sinus of Valsalva aneurysm, with cardiopulmonary bypass | 33724 | MPFS Status: Active Code APC C Illustration for Code Repair of isolated partial anomalous pulmonary venous return (eg, Scimitar Syndrome) | 33726 | MPFS Status: Active Code APC C Illustration for Code Repair of pulmonary venous stenosis | 33730 | Modifier 63 Exempt MPFS Status: Active Code APC C Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types) | 33732 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane | 33735 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type operation) | 33736 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Atrial septectomy or septostomy; open heart with cardiopulmonary bypass | 33741 | Modifier 63 Exempt MPFS Status: Active Code APC C Transcatheter atrial septostomy (TAS) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (eg, Rashkind, Sang-Park, balloon, cutting balloon, blade) | 33745 | MPFS Status: Active Code APC C Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies, and target zone angioplasty, when performed (eg, atrial septum, Fontan fenestration, right ventricular outflow tract, Mustard/Senning/Warden baffles); initial intracardiac shunt | 33746 | Add-on Code MPFS Status: Active Code APC C Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies, and target zone angioplasty, when performed (eg, atrial septum, Fontan fenestration, right ventricular outflow tract, Mustard/Senning/Warden baffles); each additional intracardiac shunt location (List separately in addition to code for primary procedure) | 33750 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation) | 33755 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Shunt; ascending aorta to pulmonary artery (Waterston type operation) | 33762 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Shunt; descending aorta to pulmonary artery (Potts-Smith type operation) | 33764 | MPFS Status: Active Code APC C Illustration for Code Shunt; central, with prosthetic graft | 33766 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical Glenn procedure) | 33767 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional Glenn procedure) | 33770 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect | 33771 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect | 33774 | Changed Code for 2025 MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; | 33775 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with removal of pulmonary band | 33776 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with closure of ventricular septal defect | 33777 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction | 33778 | Changed Code for 2025 Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); | 33779 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with removal of pulmonary band | 33780 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with closure of ventricular septal defect | 33781 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with repair of subpulmonic obstruction | 33782 | MPFS Status: Active Code APC C Illustration for Code Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); without coronary ostium reimplantation | 33783 | MPFS Status: Active Code APC C Illustration for Code Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); with reimplantation of 1 or both coronary ostia | 33786 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Total repair, truncus arteriosus (Rastelli type operation) | 33788 | MPFS Status: Active Code APC C Reimplantation of an anomalous pulmonary artery | 33800 | MPFS Status: Active Code APC C Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure) | 33802 | Changed Code for 2025 MPFS Status: Active Code APC C Division of aberrant vessel (vascular ring); | 33803 | MPFS Status: Active Code APC C Division of aberrant vessel (vascular ring); with reanastomosis | 33814 | Changed Code for 2025 MPFS Status: Active Code APC C Illustration for Code Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass | 33820 | MPFS Status: Active Code APC C Repair of patent ductus arteriosus; by ligation | 33822 | Age Edit MPFS Status: Active Code APC C Repair of patent ductus arteriosus; by division, younger than 18 years | 33824 | Age Edit MPFS Status: Active Code APC C Repair of patent ductus arteriosus; by division, 18 years and older | 33840 | MPFS Status: Active Code APC C Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis | 33845 | MPFS Status: Active Code APC C Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft | 33851 | MPFS Status: Active Code APC C Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement | 33852 | MPFS Status: Active Code APC C CPT Assistant Article Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass | 33853 | MPFS Status: Active Code APC C CPT Assistant Article Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass | 33858 | MPFS Status: Active Code APC C Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic dissection | 33859 | MPFS Status: Active Code APC C Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic disease other than dissection (eg, aneurysm) | 33863 | MPFS Status: Active Code APC C CPT Assistant Article Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction (eg, Bentall) | 33864 | MPFS Status: Active Code APC C Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodeling (eg, David Procedure, Yacoub Procedure) | 33866 | Add-on Code MPFS Status: Active Code APC N ASC N1 Aortic hemiarch graft including isolation and control of the arch vessels, beveled open distal aortic anastomosis extending under one or more of the arch vessels, and total circulatory arrest or isolated cerebral perfusion (List separately in addition to code for primary procedure) | 33871 | MPFS Status: Active Code APC C Transverse aortic arch graft, with cardiopulmonary bypass, with profound hypothermia, total circulatory arrest and isolated cerebral perfusion with reimplantation of arch vessel(s) (eg, island pedicle or individual arch vessel reimplantation) | 33875 | MPFS Status: Active Code APC C Descending thoracic aorta graft, with or without bypass | 33877 | MPFS Status: Active Code APC C Physician Quality Reporting Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass | 33910 | MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Pulmonary artery embolectomy; with cardiopulmonary bypass | 33915 | MPFS Status: Active Code APC C PUB 100 Pulmonary artery embolectomy; without cardiopulmonary bypass | 33916 | MPFS Status: Active Code APC C PUB 100 Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass | 33917 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of pulmonary artery stenosis by reconstruction with patch or graft | 33920 | MPFS Status: Active Code APC C CPT Assistant Article Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery | 33922 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Transection of pulmonary artery with cardiopulmonary bypass | 33925 | MPFS Status: Active Code APC C Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass | 33926 | MPFS Status: Active Code APC C Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass | 33975 | MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Insertion of ventricular assist device; extracorporeal, single ventricle | 33976 | MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Insertion of ventricular assist device; extracorporeal, biventricular | 33977 | MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Removal of ventricular assist device; extracorporeal, single ventricle | 33978 | MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Removal of ventricular assist device; extracorporeal, biventricular | 33979 | MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Insertion of ventricular assist device, implantable intracorporeal, single ventricle | 33980 | MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Illustration for Code Removal of ventricular assist device, implantable intracorporeal, single ventricle | 33981 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump | 33982 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass | 33983 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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Notes
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| 2019-11-19 | Changed | per CPT Errata, correction made to CPT Guideline |
| 2017-01-01 | Changed | Guidelines changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2008-01-01 | Added | First appearance in code book in 2008. |
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