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Coronary artery bypass graft (CABG) is a surgical procedure aimed at improving blood flow to the heart by bypassing blocked or narrowed coronary arteries. This procedure is critical for patients suffering from ischemic heart disease, which can lead to serious conditions such as myocardial infarction (heart attack). The coronary arteries are responsible for delivering oxygen-rich blood to the heart muscle, and any obstruction in these arteries can significantly impair heart function. In CABG, surgeons utilize a combination of venous and arterial grafts to create a new pathway for blood to flow, effectively circumventing the areas of blockage. The procedure typically involves harvesting veins, often the greater saphenous veins from the legs, which are then prepared for grafting. During the surgery, an incision is made in the chest, the sternum is divided, and the ribs are retracted to gain access to the heart. Depending on the patient's condition, the surgery may be performed using an off-pump technique, which allows the procedure to be conducted on a beating heart, or through cardiopulmonary bypass, where the heart is temporarily stopped and a machine takes over its pumping function. The prepared vein grafts are meticulously sewn into place, connecting one end to the ascending aorta and the other end to the coronary artery beyond the blockage. This specific code, CPT® 33523, is used to report the use of six or more venous grafts in conjunction with arterial grafts, ensuring accurate documentation and billing for the extensive nature of the procedure.
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The procedure is indicated for patients with significant coronary artery disease characterized by the following conditions:
The CABG procedure involves several critical steps to ensure successful grafting and restoration of blood flow to the heart:
Post-procedure care is essential for recovery and includes monitoring in a cardiac intensive care unit (ICU) for several days. Patients are observed for any complications such as bleeding, infection, or arrhythmias. Pain management is provided, and patients are encouraged to begin light physical activity as soon as they are stable. Cardiac rehabilitation may be recommended to aid recovery and improve cardiovascular health. Follow-up appointments are necessary to assess the success of the grafts and overall heart function.
| Short Descr | CABG ART-VEIN SIX OR MORE | Medium Descr | CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN | Long Descr | Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (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) | P2A - Major procedure, cardiovascular-CABG | MUE | 1 | CCS Clinical Classification | 44 - Coronary artery bypass graft (CABG) |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 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 | 33141 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting PUB 100 CPT Assistant Article Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separately in addition to code for primary procedure) | 33508 | Addon Code MPFS Status: Active Code APC N ASC N1 Illustration for Code Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to code for primary procedure) | 33530 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (List separately in addition to code for primary procedure) | 35500 | Addon Code MPFS Status: Active Code APC N CPT Assistant Article Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (List separately in addition to code for primary procedure) | 35572 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in addition to code for primary procedure) |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2008-01-01 | Changed | Code description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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