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The CPT® Code 33877 refers to the surgical procedure known as the repair of a thoracoabdominal aortic aneurysm using a graft, which may be performed with or without the use of cardiopulmonary bypass. A thoracoabdominal aortic aneurysm is a serious condition characterized by an abnormal dilation of the aorta that occurs in the thoracic region and extends into the abdominal aorta. This type of aneurysm typically originates below the left subclavian artery and can pose significant risks, including rupture and life-threatening hemorrhage. The procedure involves a thoracoabdominal approach, which requires careful dissection and exposure of the aorta. During the surgery, the aneurysm sac is opened, and any thrombus or plaque is removed to facilitate the placement of a synthetic tube graft or conduit. This graft is then sutured to the healthy segments of the aorta, both proximal and distal to the aneurysm site, ensuring proper blood flow is restored. The procedure is complex and requires meticulous attention to detail, particularly when managing the surrounding structures, such as the lumbar and inferior mesenteric arteries, and ensuring that blood flow to the renal arteries is preserved if the aneurysm extends to that area. The successful completion of this procedure is critical for preventing complications associated with thoracoabdominal aortic aneurysms.
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The procedure described by CPT® Code 33877 is indicated for patients diagnosed with thoracoabdominal aortic aneurysms. These aneurysms can lead to serious complications, including rupture, which can be life-threatening. The following conditions may warrant the performance of this surgical intervention:
The surgical procedure for CPT® Code 33877 involves several critical steps to ensure the successful repair of the thoracoabdominal aortic aneurysm:
Post-procedure care following the repair of a thoracoabdominal aortic aneurysm includes monitoring for complications such as bleeding, infection, or graft failure. Patients may require intensive care for a period following surgery to ensure stable hemodynamics and to manage any potential complications. Pain management and gradual mobilization are essential components of recovery. Follow-up imaging studies may be necessary to assess the integrity of the graft and the aorta, ensuring that there are no signs of complications such as aneurysm recurrence or graft-related issues. The healthcare team will provide specific instructions regarding activity restrictions and follow-up appointments to monitor the patient's recovery progress.
| Short Descr | THORACOABDOMINAL GRAFT | Medium Descr | RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS | Long Descr | Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 52 - Aortic resection, replacement or anastomosis |
This is a primary code that can be used with these additional add-on codes.
| 33257 | Addon Code MPFS Status: Active Code APC C Illustration for Code 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) | 33258 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (List separately in addition to code for primary procedure) | 33259 | Addon Code MPFS Status: Active Code APC C Illustration for Code 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) | 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) |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | 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. | 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. | 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. | 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.) | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | ET | Emergency services | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| Pre-1990 | Added | Code added. |
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