Summary & Overview
CPT 33405: Surgical Replacement of Aortic Valve with Prosthetic Device
CPT code 33405 represents the surgical replacement of the aortic valve with a prosthetic device, excluding homograft or stentless valves, utilizing cardiopulmonary bypass. This procedure is a cornerstone of cardiothoracic surgery, addressing critical aortic valve conditions such as stenosis and insufficiency. The code is widely recognized across major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, reflecting its importance in both clinical and reimbursement contexts.
This publication provides a comprehensive overview of 33405, including payer coverage, clinical indications, and related coding benchmarks. Readers will gain insight into the procedural context, typical site of service, and how this code fits within broader surgical and cardiovascular care pathways. Policy updates, coding nuances, and comparisons to related procedures are also discussed, offering a clear understanding of how 33405 is utilized in hospital settings nationwide. The analysis is designed to inform stakeholders about current trends, payer policies, and clinical relevance, supporting informed decision-making in medical billing and healthcare administration.
CPT Code Overview
CPT code 33405 describes the replacement of the aortic valve with a prosthetic valve, excluding homograft or stentless valves, performed with cardiopulmonary bypass. This procedure is a key component of cardiothoracic surgery and is typically conducted in an inpatient hospital setting (Place of Service 21). The operation addresses severe aortic valve disease and is essential for patients requiring surgical intervention to restore normal cardiac function.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient admitted to an inpatient hospital with severe symptomatic aortic valve disease, such as aortic stenosis or aortic insufficiency. The patient may present with symptoms including chest pain, shortness of breath, or syncope. After diagnostic evaluation confirms the need for surgical intervention, the patient undergoes replacement of the aortic valve using a prosthetic valve (other than homograft or stentless valve) with cardiopulmonary bypass. The procedure is performed by a cardiothoracic surgeon in a hospital operating room setting.
Coding Specifications
Modifiers:
| Modifier Code | Description | When Used |
|---|---|---|
22 | Increased Procedural Services | When the procedure requires significant additional work beyond typical services. |
51 | Multiple Procedures | When more than one procedure is performed during the same operative session. |
Provider Taxonomies:
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208G00000X- Thoracic Surgery (Cardiothoracic Vascular Surgery): Specialists performing complex heart and chest surgeries. -
208600000X- Surgery Physician: General surgeons who may participate in cardiac procedures. -
207RC0000X- Cardiovascular Disease Physician: Physicians specializing in cardiovascular diseases, often involved in perioperative care.
Related Diagnoses
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I35.0- Nonrheumatic aortic (valve) stenosis- Indicates narrowing of the aortic valve not caused by rheumatic disease. Common indication for aortic valve replacement.
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I35.1- Nonrheumatic aortic (valve) insufficiency- Refers to leakage of the aortic valve not due to rheumatic disease. May necessitate valve replacement.
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I35.2- Nonrheumatic aortic (valve) stenosis with insufficiency- Combination of narrowing and leakage of the aortic valve, nonrheumatic origin. Often requires surgical intervention.
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I06.0- Rheumatic aortic stenosis- Aortic valve narrowing resulting from rheumatic heart disease. Surgical replacement may be indicated.
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I06.2- Rheumatic aortic stenosis with insufficiency- Both stenosis and insufficiency of the aortic valve due to rheumatic disease. Replacement is a common treatment.
Related CPT Codes
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33406- Replacement, aortic valve, with cardiopulmonary bypass; with stentless tissue valve- Used when the aortic valve is replaced with a stentless tissue valve instead of a prosthetic valve. Alternative to
33405depending on valve type.
- Used when the aortic valve is replaced with a stentless tissue valve instead of a prosthetic valve. Alternative to
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33410- Replacement, aortic valve, with cardiopulmonary bypass; with homograft valve- Used when a homograft valve is utilized for replacement. Alternative to
33405based on valve selection.
- Used when a homograft valve is utilized for replacement. Alternative to
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33533- Coronary artery bypass, using arterial graft(s); single arterial graft- May be performed concurrently with aortic valve replacement if coronary artery disease is present. Commonly coded together with
33405when both procedures are done in the same session.
- May be performed concurrently with aortic valve replacement if coronary artery disease is present. Commonly coded together with
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92986- Percutaneous balloon valvuloplasty; aortic valve- Represents a less invasive, catheter-based procedure for aortic valve stenosis. Used as an alternative to surgical replacement in select cases.
National Reimbursement Benchmarks
Nationally, the mean rate for CPT code 33405 under Medicare is $2,135.50, while the average commercial mean rate (BUCA) is $2,960.18. This indicates that commercial payers generally reimburse at higher rates than Medicare for this procedure.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare shows the tightest range at $168.00, reflecting relatively consistent reimbursement. In contrast, UnitedHealth Group exhibits the widest dispersion at $2,373.00, suggesting greater variability in contracted rates. Cigna and Blue Cross Blue Shield also display substantial ranges, at $2,115.00 and $1,495.67 respectively.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.