Physician Reimbursement ®4 Clinicians use Current Procedural Terminology (CPT®) codes to bill for procedures and services. Each CPT® code is assigned unique Relative Value Units (RVUs), which are used to determine payment by the Centers for Medicare & Medicaid Services (CMS). Non-Medicare payers may also use this information as a reference for provider reimbursement. The most commonly reported procedure CPT® codes used to describe the procedures related to placement Artivion’s AMDS Hybrid Prosthesis are listed below. This list is not intended be comprehensive and may include some procedures that are not medically indicated for every patient. Procedure code selection should be based upon the medically necessary procedures that are performed during each individual patient encounter. Providers should also be aware of National Correct Coding Initiative edits. The physician payment rates provided below are the 2025 national average Medicare Physician Fee Schedule (MPFS) and have not been adjusted for sequestration. Providers should be aware that the procedures may be subject to the CMS multiple procedure reduction rule. When applicable, 100% payment is made for the procedure with the greatest RVUs, and a payment reduction of 50% may be applied to the additional procedures reported. There is no specific CPT® code to report placement of the AMDS hybrid prosthesis. As such, the unlisted code for cardiac surgery should be reported (CPT® 33999). The physician should provide supporting documentation that describes the procedure and resources used in the operative notes. In addition, a concise description of the procedure should be included in Loop 2300 of the CMS-1500 claim form.
CPT®
Description
MPFS 5
33858 Ascending Aorta Graft, with Cardiopulmonary Bypass, Includes Valve Suspension, When Performed; for Aortic Dissection 33863 Ascen ding Aorta Graft, with Cardiopulmonary Bypass, with Aortic Root Replacement Using Valved Conduit and Coronary Reconstruction (e.g., Bentall)
$3,228
$2,991
Ascending Aorta Graft, with Cardiopulmonary Bypass with Valve Suspension, with Coronary Reconstruction and Valve-Sparing Aortic Root Remodeling (e.g., David Procedure, Yacoub Procedure)
33864
$3,057
33866 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) $873 33871 Transverse aortic arch graft, with cardiopulmonary bypass, with profound hypothermia, total circulatory arrest, and isolated cerebral perfusion with reimplantation of arch vessels 3,094 33875 Descending Thoracic Aorta Graft, with or Without Bypass $2,608 33877 Thoracoabdominal Aortic Aneurysm Repair with Graft, with or Without Cardiopulmonary Bypass $3,425 33999 Unlisted Procedure, Cardiac Surgery (for Placement of the AMDS Device) By Report
Reimbursement Guide - Effective 10/01/2025 | 5
Made with FlippingBook Online newsletter maker