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Official Description

Removal of ventricular assist device, implantable intracorporeal, single ventricle

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 33980 refers to the surgical procedure for the removal of a ventricular assist device (VAD) that is implantable and intracorporeal, specifically designed for a single ventricle. This procedure is typically indicated for patients who have had a VAD implanted to support heart function due to severe heart failure or other cardiac conditions. The removal process involves reopening the previous sternal incision to access the chest cavity, as well as opening the VAD pocket located in the abdomen. The procedure may vary slightly depending on whether the VAD is positioned on the left or right ventricle, but generally includes the initiation of cardiopulmonary bypass and careful dissection of adhesions surrounding the heart and VAD. The VAD is then detached from its inflow component, and the necessary steps are taken to ensure the heart and surrounding structures are properly closed and secured after the device is removed. This complex surgical intervention requires meticulous attention to detail to prevent complications and ensure patient safety during the recovery process.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 33980 is indicated for patients who require the removal of a ventricular assist device (VAD) due to various clinical reasons. These may include:

  • Device malfunction - Situations where the VAD is not functioning as intended, leading to inadequate support for the heart.
  • Patient recovery - Instances where the patient's heart function has improved sufficiently to no longer require mechanical support.
  • Complications - Cases where the presence of the VAD has led to complications such as infection or thrombosis.
  • Transition to heart transplantation - Patients who are transitioning to heart transplantation may require the removal of the VAD as part of the surgical process.

2. Procedure

The procedure for the removal of a ventricular assist device involves several critical steps, which are detailed as follows:

  • Step 1: The previous sternal incision is reopened to gain access to the chest cavity. This allows the surgeon to visualize and access the heart and the VAD.
  • Step 2: The VAD pocket located in the abdomen is also opened to facilitate the removal of the device. This step is crucial for accessing the driveline and other components of the VAD.
  • Step 3: If a left VAD is being removed, the outflow graft is cannulated to the right atrium. This step is essential for initiating cardiopulmonary bypass, which temporarily takes over the function of the heart and lungs during the procedure.
  • Step 4: Cardiopulmonary bypass is initiated, and cardioplegia is induced to protect the heart during the surgery by temporarily stopping its function.
  • Step 5: The surgeon carefully dissects any adhesions around the heart and the VAD to free the device from surrounding tissues, ensuring that no damage occurs to the heart or other structures.
  • Step 6: The VAD is detached from the inflow component, and the driveline is dissected from the surrounding tissue, allowing for the complete removal of the device.
  • Step 7: The inflow cuff is removed from the left ventricle, and the cored hole in the apex of the ventricle is closed with sutures, which are reinforced with a synthetic patch to ensure proper healing.
  • Step 8: The patient is weaned from cardiopulmonary bypass, and the cannula is removed from the aortic outflow graft. The graft is then divided close to the aorta, and the graft stump is sutured closed.
  • Step 9: Suture sites are checked for hemostasis, and reinforcement is provided as needed to prevent bleeding.
  • Step 10: Pacing wires are placed on the heart, and chest tubes are inserted to facilitate drainage and prevent fluid accumulation.
  • Step 11: A drain is placed in the abdominal pocket to manage any potential fluid collection post-surgery.
  • Step 12: Finally, the chest and abdominal incisions are closed, completing the procedure.
  • Step 13: If a right VAD is being removed, the procedure follows a similar approach, with the VAD being detached from the outflow component in the right ventricle. The pulmonary artery inflow graft is divided, and the graft stump is closed. The outflow cuff is removed from the right ventricle, and the cored hole in the right ventricle is closed with sutures reinforced with a synthetic patch.

3. Post-Procedure

Post-procedure care following the removal of a ventricular assist device is critical for patient recovery. Patients are typically monitored closely in a postoperative setting for any signs of complications, such as bleeding or infection. The surgical sites, both in the chest and abdomen, are assessed for proper healing and any signs of fluid accumulation. Pain management is provided as needed, and patients may require additional support for their heart function as they recover. Follow-up appointments are essential to monitor the patient's progress and to ensure that the heart is functioning adequately without the support of the VAD. Rehabilitation and gradual return to normal activities are often part of the recovery process, depending on the patient's overall health and specific circumstances surrounding the surgery.

Short Descr REMOVE INTRACORPOREAL DEVICE
Medium Descr RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC
Long Descr Removal of ventricular assist device, implantable intracorporeal, single ventricle
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
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) 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) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 49 - Other OR heart procedures

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)
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)
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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.)
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
GC This service has been performed in part by a resident under the direction of a teaching physician
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
Date
Action
Notes
2022-01-01 Changed AMA guideline removed.
2017-01-01 Changed Guideline added.
2002-01-01 Added First appearance in code book in 2002.
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