CPT® Code 33250

Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass

The CPT® Code 33250 refers to the operative ablation of a supraventricular arrhythmogenic focus or pathway, which includes conditions such as Wolff-Parkinson-White syndrome and atrioventricular node re-entry. These conditions are characterized by the presence of additional electrical pathways that can lead to episodes of supraventricular tachycardia, a type of rapid heart rate originating above the ventricles. The procedure is performed without the use of cardiopulmonary bypass, meaning that the heart remains beating throughout the operation. Access to the heart is typically achieved through a midline sternotomy, which involves making an incision along the sternum. During the procedure, both epicardial and endocardial electrodes are placed on the heart to facilitate pacing and mapping, allowing the medical team to accurately locate the abnormal electrical pathways responsible for the arrhythmia. The ablation itself can be performed using various techniques, including surgical incision, cryoablation, or radiofrequency ablation, to effectively destroy the abnormal pathways. Following the ablation, the heart incision is closed, and if cardiopulmonary bypass was not utilized, the procedure concludes without the need for additional support systems. This code is specifically designated for cases where the ablation is performed on a beating heart, distinguishing it from similar procedures that may require the heart to be stopped and cardiopulmonary bypass to be established.