Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
Pulmonary endarterectomy is a surgical procedure aimed at treating chronic thromboembolic pulmonary hypertension, a condition characterized by high blood pressure in the pulmonary arteries due to blood clots that obstruct blood flow. This procedure involves the removal of these obstructions to restore normal blood flow and improve heart function. The surgery typically requires access to the heart through a median sternotomy or thoracotomy, which involves making an incision in the chest to expose the heart and surrounding structures. During the procedure, the pericardium, the protective sac surrounding the heart, is incised to allow for better access to the proximal main pulmonary artery. To facilitate the surgery, the aorta and the superior and inferior vena cava are cannulated, and cardiopulmonary bypass is established, which temporarily takes over the function of the heart and lungs, allowing the surgeon to operate on a still heart. The main pulmonary artery is then incised, and if any emboli are present, they are removed. The procedure focuses on establishing the correct endarterectomy plane to effectively excise fibrous obstructive tissue from the main pulmonary artery and its branches, including the right and left pulmonary arteries, as well as lobar, segmental, and subsegmental branches. The endarterectomy is performed on one lung at a time, with reperfusion occurring after the first lung's procedure is completed, followed by a second period of cardiac arrest to perform the same procedure on the contralateral lung. Finally, the incisions in the pulmonary arteries are closed, chest tubes may be placed as necessary, and the chest incision is closed to complete the surgery.
© Copyright 2026 Coding Ahead. All rights reserved.
The pulmonary endarterectomy procedure is indicated for patients suffering from chronic thromboembolic pulmonary hypertension, which is often a result of unresolved pulmonary emboli that have led to significant vascular obstruction. This condition can cause symptoms such as exertional dyspnea, fatigue, and chest pain, which may progressively worsen over time. The procedure aims to alleviate these symptoms and improve the patient's overall hemodynamic status by removing the obstructive thrombi from the pulmonary arteries.
The pulmonary endarterectomy procedure involves several critical steps to ensure successful removal of the obstructive tissue from the pulmonary arteries.
Post-procedure care for patients who have undergone pulmonary endarterectomy typically involves close monitoring in a recovery unit. Patients may require supplemental oxygen and will be observed for any signs of complications, such as bleeding or infection. The placement of chest tubes, if necessary, will aid in the drainage of any fluid accumulation. Recovery may involve pain management and gradual mobilization to promote healing. The healthcare team will provide specific instructions regarding activity restrictions and follow-up appointments to monitor the patient's recovery and assess the success of the procedure.
| Short Descr | SURGERY OF GREAT VESSEL | Medium Descr | PULMONARY ENDARTERCOMY W/WO EMBOLECTOMY W/BYPASS | Long Descr | Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
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) |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 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). | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 1990-01-01 | Added | First appearance in code book in 1990. |
Get instant expert-level medical coding assistance.