© Copyright 2025 American Medical Association. All rights reserved.
Operative tissue ablation and reconstruction of the atria, as described by CPT® Code 33259, refers to a complex surgical procedure aimed at correcting chronic atrial fibrillation, which is characterized by rapid and uncoordinated contractions of the upper chambers of the heart, leading to an irregular and often rapid heartbeat. This extensive procedure is typically performed in conjunction with other cardiac surgeries, particularly during a maze procedure, which is designed to create new electrical pathways in the heart. The maze procedure interrupts the abnormal electrical circuits that contribute to atrial fibrillation, allowing for the restoration of normal electrical conduction from the sinoatrial node to the atrioventricular node. The procedure is conducted under cardiopulmonary bypass, which is a technique that temporarily takes over the function of the heart and lungs during surgery, ensuring that blood continues to circulate and oxygenate the body. The surgical approach involves making incisions in the left atrium, often through the interatrial groove, and utilizing a sling around the inferior vena cava to enhance visibility and access to the heart structures. The excision of the atrial appendage and the creation of precise incisions in the atrial tissue are critical steps that prevent the conduction of abnormal impulses, thereby allowing the atria to regain normal contractions and size. The suturing of incision sites and the use of a pericardial strip for reinforcement are essential for ensuring the integrity of the surgical site. Ultimately, this procedure aims to restore the atrial function, enabling it to effectively hold and pump blood to the ventricles while eliminating the fibrillation that characterizes atrial fibrillation.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 33259 is indicated for patients suffering from chronic atrial fibrillation, which is characterized by rapid and uncoordinated contractions of the atria. This condition can lead to various complications, including stroke and heart failure, necessitating intervention. The maze procedure, which involves extensive operative tissue ablation and reconstruction of the atria, is performed to restore normal electrical conduction and improve the overall function of the heart. It is specifically indicated when the patient is undergoing other cardiac procedures that are separately reportable, and it is essential for addressing the underlying issues associated with atrial fibrillation.
The procedure involves several critical steps that are performed during the maze procedure under cardiopulmonary bypass. First, after establishing cardiopulmonary bypass, both vena cavae are cannulated to facilitate venous return. Following this, the heart is placed in cardioplegic arrest to ensure it remains still and bloodless during the surgical intervention. The left atrium is then incised through the interatrial groove, providing access to the atrial structures. A sling is strategically placed around the inferior vena cava to lift and rotate the heart, enhancing visibility and access for the surgeon. Next, the atrial appendage is excised, which is an important step in reducing the risk of thrombus formation. Precise incisions are made in the atrial tissue to interrupt the conduction of abnormal electrical impulses. These incisions are designed to create a maze-like pattern that allows normal electrical impulses to travel from the sinoatrial node to the atrioventricular node, thereby restoring normal atrial contractions and size. After the necessary incisions are made, the incision sites are sutured closed, and a pericardial strip is utilized for reinforcement of the suture lines. This ensures that the atrium can effectively hold and pump blood to the ventricles while preventing the electrical impulses from crossing the incisions, thus eliminating the fibrillation associated with atrial fibrillation. It is important to note that the maze procedure may be performed on either the left atrium alone or on both atria, depending on the specific needs of the patient.
After the completion of the maze procedure and the operative tissue ablation and reconstruction of the atria, patients typically require close monitoring in a postoperative setting. The expected recovery involves careful observation for any complications related to the surgery, such as bleeding or infection. Patients may also need to be monitored for the restoration of normal heart rhythm and function. Follow-up care is essential to assess the effectiveness of the procedure in managing atrial fibrillation and to make any necessary adjustments to medications or further interventions. Rehabilitation and gradual return to normal activities are often recommended, with specific guidelines provided by the healthcare team based on the individual patient's condition and recovery progress.
| Short Descr | ABLATE ATRIA W/BYPASS ADD-ON | Medium Descr | ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS | Long Descr | Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (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 | 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 | 33305 | MPFS Status: Active Code APC C Physician Quality Reporting Repair of cardiac wound; with cardiopulmonary 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 | 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 | 33335 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Insertion of graft, aorta or great vessels; with cardiopulmonary bypass | 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 | 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 | 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) | 33620 | MPFS Status: Active Code APC C Application of right and left pulmonary artery bands (eg, hybrid approach stage 1) | 33621 | MPFS Status: Active Code APC C Transthoracic insertion of catheter for stent placement with catheter removal and closure (eg, hybrid approach stage 1) | 33622 | MPFS Status: Active Code APC C Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aortic outflow obstruction and aortic arch hypoplasia, creation of cavopulmonary anastomosis, and removal of right and left pulmonary bands (eg, hybrid approach stage 2, Norwood, bidirectional Glenn, pulmonary artery debanding) | 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 | 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 | 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 | 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 | 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 | 33814 | Changed Code for 2025 MPFS Status: Active Code APC C Illustration for Code Obliteration of aortopulmonary septal defect, with 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 | 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 | 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 | 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 | 34714 | Addon Code MPFS Status: Active Code APC N ASC N1 Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure) | 34716 | Addon Code MPFS Status: Active Code APC N ASC N1 Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure) | 34833 | Addon Code Resequenced Code MPFS Status: Active Code APC C CPT Assistant Article Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure) |
| 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 | 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). | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure 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. | 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.) | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | AG | Primary physician | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | ET | Emergency services | 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 | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | 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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| 2020-01-01 | Note | AMA Guidelines changed. |
| 2017-01-01 | Changed | Guidelines changed. |
| 2017-01-01 | Note | AMA Guidelines changed. |
| 2008-01-01 | Added | First appearance in code book in 2008. |
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