CPT® Code 33251

Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass

The CPT® Code 33251 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 involves a midline sternotomy, which is a surgical incision made along the sternum to provide access to the heart. During the operation, 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. If necessary, cardiopulmonary bypass is established to temporarily take over the function of the heart and lungs, allowing for a controlled environment during the procedure. The right atrium is then incised to access the abnormal pathways, which are subsequently destroyed through surgical incision, cryoablation, or radiofrequency ablation techniques. Following the ablation, the heart incision is closed, and if cardiopulmonary bypass was utilized, it is discontinued. Chest tubes may be placed as needed to drain any fluid, and the chest incision is then closed. This code is specifically used when the ablation procedure is performed with the heart stopped and cardiopulmonary bypass in place, distinguishing it from similar procedures performed on a beating heart, which would be reported with CPT® Code 33250.