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Home , Aortic valve repair, Aortic valve replacement, Mitral valve repair, Mitral valve replacement, Pericardial window, Pericardiectomy

SJH Procedures - Cardiac/Open Service New Name Old Name CPT Code Service BIOPSY OR EXCISION, LESION, UPPER BODY, 2 OR MORE EXCISE/BIOPSY (MASS/LESION/LIPOMA/CYST) MULTIPLE UPPER BODY 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Gynecology, single lesion Orthopedics, Plastics, Aesthetics, Cardiac/Thoracic Robotics, Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Vascular 11103 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Gynecology, each separate/additional lesion (list separately in addition to Orthopedics, Plastics, code for primary procedure) Aesthetics, Cardiac/Thoracic Robotics, Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Vascular 11104 Punch biopsy of skin (including simple closure, when General, Gynecology, performed); single lesion Orthopedics, Plastics, Aesthetics, Cardiac/Thoracic Robotics, Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Vascular 11105 Punch biopsy of skin (including simple closure, when General, Gynecology, performed); each separate/additional lesion (list separately in Orthopedics, Plastics, addition to code for primary procedure) Aesthetics, Cardiac/Thoracic Robotics, Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Vascular 11106 Incisional biopsy of skin (eg, wedge) (including simple closure, General, Gynecology, when performed); single lesion Orthopedics, Plastics, Aesthetics, Cardiac/Thoracic Robotics, Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Vascular 11107 Incisional biopsy of skin (eg, wedge) (including simple closure, General, Gynecology, when performed); each separate/additional lesion (list Orthopedics, Plastics, separately in addition to code for primary procedure) Aesthetics, Cardiac/Thoracic Robotics, Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Vascular BIOPSY OR EXCISION, LESION, UPPER BODY, USING CO2 LASER EXCISE/BIOPSY (MASS/LESION/LIPOMA/CYST) UPPER BODY W CO2 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Aesthetics, single lesion Cardiac/Thoracic Robotics, Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Orthopedics, Plastics 11104 Punch biopsy of skin (including simple closure, when General, Aesthetics, performed); single lesion Cardiac/Thoracic Robotics, Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Orthopedics, Plastics

Page 1 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service BIOPSY OR EXCISION, LESION, UPPER BODY, USING CO2 LASER EXCISE/BIOPSY (MASS/LESION/LIPOMA/CYST) UPPER BODY W CO2 11106 Incisional biopsy of skin (eg, wedge) (including simple closure, General, Aesthetics, when performed); single lesion Cardiac/Thoracic Robotics, Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Orthopedics, Plastics 17000 Destruction (eg, laser , electrosurgery, cryosurgery, General, Aesthetics, chemosurgery, surgical curettement), premalignant lesions (eg, Cardiac/Thoracic Robotics, actinic keratoses); first lesion Cardiovascular, Colorectal, ENT, Maxillofacial, Spine, Orthopedics, Plastics BYPASS AORTO-CAROTID/INNOMINATE ARTERY Cardiac/Open Heart CLIPPING, ATRIAL APPENDAGE, LEFT APPROACH THORACOTOMY LEFT W APPLICATION OF ATRIAL APPENDAGE CLIP 33999 Unlisted procedure, Cardiac/Open Heart CORONARY ARTERY BYPASS GRAFT (CABG), REPEAT, WITH ENDOSCOPIC CORONARY GRAFTS REDO W ENDOSCOPIC HARVEST *33510 Coronary artery bypass, vein only; single coronary venous graft Cardiac/Open Heart VASCULAR GRAFT PROCUREMENT *33511 Coronary artery bypass, vein only; 2 coronary venous grafts Cardiac/Open Heart *33512 Coronary artery bypass, vein only; 3 coronary venous grafts Cardiac/Open Heart *33513 Coronary artery bypass, vein only; 4 coronary venous grafts Cardiac/Open Heart *33514 Coronary artery bypass, vein only; 5 coronary venous grafts Cardiac/Open Heart *33516 Coronary artery bypass, vein only; 6 or more coronary venous Cardiac/Open Heart grafts *33517 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); single vein graft (List separately in addition to code for primary procedure) *33518 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 2 venous grafts (List separately in addition to code for primary procedure) *33519 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 3 venous grafts (List separately in addition to code for primary procedure) *33521 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 4 venous grafts (List separately in addition to code for primary procedure) *33522 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 5 venous grafts (List separately in addition to code for primary procedure) *33523 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 6 or more venous grafts (List separately in addition to code for primary procedure) *33530 Reoperation, coronary artery bypass procedure or valve Cardiac/Open Heart procedure, more than 1 month after original operation (List separately in addition to code for primary procedure) *33533 Coronary artery bypass, using arterial graft(s); single arterial Cardiac/Open Heart graft *33534 Coronary artery bypass, using arterial graft(s); 2 coronary Cardiac/Open Heart arterial grafts *33535 Coronary artery bypass, using arterial graft(s); 3 coronary Cardiac/Open Heart arterial grafts

Page 2 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service CORONARY ARTERY BYPASS GRAFT (CABG), REPEAT, WITH ENDOSCOPIC CORONARY GRAFTS REDO W ENDOSCOPIC HARVEST *33536 Coronary artery bypass, using arterial graft(s); 4 or more Cardiac/Open Heart VASCULAR GRAFT PROCUREMENT coronary arterial grafts CORONARY ARTERY BYPASS GRAFT (CABG), USING INTERNAL THORACIC CORONARY GRAFT MINIMAL INVASIVE MAMMARY ARTERY TAKEDOWN XI *33533 Coronary artery bypass, using arterial graft(s); single arterial Cardiac/Thoracic Robotics ARTERY, ROBOT-ASSISTED, USING XI ROBOTICS graft CORONARY ARTERY BYPASS GRAFT (CABG), WITH CORONARY GRAFTS REPLACE AORTIC+REPAIR/REPLACE MITRAL VALVES *33405 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart REPLACEMENT AND REPAIR OR REPLACEMENT bypass; with prosthetic valve other than homograft or stentless valve *33406 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with allograft valve (freehand) *33410 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with stentless tissue valve *33411 Replacement, aortic valve; with aortic annulus enlargement, Cardiac/Open Heart noncoronary sinus *33412 Replacement, aortic valve; with transventricular aortic annulus Cardiac/Open Heart enlargement (Konno procedure) *33425 Valvuloplasty, mitral valve, with ; Cardiac/Open Heart *33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with Cardiac/Open Heart prosthetic ring *33427 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart radical reconstruction, with or without ring *33430 Replacement, mitral valve, with cardiopulmonary bypass Cardiac/Open Heart 33440 Replacement, aortic valve; by translocation of autologous Cardiac/Open Heart and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (Ross-Konno procedure) *33510 Coronary artery bypass, vein only; single coronary venous graft Cardiac/Open Heart *33511 Coronary artery bypass, vein only; 2 coronary venous grafts Cardiac/Open Heart *33512 Coronary artery bypass, vein only; 3 coronary venous grafts Cardiac/Open Heart *33513 Coronary artery bypass, vein only; 4 coronary venous grafts Cardiac/Open Heart *33514 Coronary artery bypass, vein only; 5 coronary venous grafts Cardiac/Open Heart *33516 Coronary artery bypass, vein only; 6 or more coronary venous Cardiac/Open Heart grafts *33533 Coronary artery bypass, using arterial graft(s); single arterial Cardiac/Open Heart graft *33534 Coronary artery bypass, using arterial graft(s); 2 coronary Cardiac/Open Heart arterial grafts *33535 Coronary artery bypass, using arterial graft(s); 3 coronary Cardiac/Open Heart arterial grafts *33536 Coronary artery bypass, using arterial graft(s); 4 or more Cardiac/Open Heart coronary arterial grafts CORONARY ARTERY BYPASS GRAFT (CABG), WITH ENDOSCOPIC VESSEL CORONARY GRAFTS W ENDOSCOPIC HARVEST 33508 Endoscopy, surgical, including video-assisted harvest of vein(s) Cardiac/Open Heart PROCUREMENT for coronary artery bypass procedure (List separately in addition to code for primary procedure) *33510 Coronary artery bypass, vein only; single coronary venous graft Cardiac/Open Heart *33511 Coronary artery bypass, vein only; 2 coronary venous grafts Cardiac/Open Heart *33512 Coronary artery bypass, vein only; 3 coronary venous grafts Cardiac/Open Heart

Page 3 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service CORONARY ARTERY BYPASS GRAFT (CABG), WITH ENDOSCOPIC VESSEL CORONARY GRAFTS W ENDOSCOPIC HARVEST *33513 Coronary artery bypass, vein only; 4 coronary venous grafts Cardiac/Open Heart PROCUREMENT *33514 Coronary artery bypass, vein only; 5 coronary venous grafts Cardiac/Open Heart *33516 Coronary artery bypass, vein only; 6 or more coronary venous Cardiac/Open Heart grafts *33517 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); single vein graft (List separately in addition to code for primary procedure) *33518 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 2 venous grafts (List separately in addition to code for primary procedure) *33519 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 3 venous grafts (List separately in addition to code for primary procedure) *33521 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 4 venous grafts (List separately in addition to code for primary procedure) *33522 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 5 venous grafts (List separately in addition to code for primary procedure) *33523 Coronary artery bypass, using venous graft(s) and arterial Cardiac/Open Heart graft(s); 6 or more venous grafts (List separately in addition to code for primary procedure) *33533 Coronary artery bypass, using arterial graft(s); single arterial Cardiac/Open Heart graft *33534 Coronary artery bypass, using arterial graft(s); 2 coronary Cardiac/Open Heart arterial grafts *33535 Coronary artery bypass, using arterial graft(s); 3 coronary Cardiac/Open Heart arterial grafts *33536 Coronary artery bypass, using arterial graft(s); 4 or more Cardiac/Open Heart coronary arterial grafts CORONARY ARTERY BYPASS GRAFT (CABG), WITH ENDOSCOPIC VESSEL CORONARY GRAFTS W ENDOSCOPIC HARVEST REPLACE AORTIC VALVE *33405 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart PROCUREMENT AND AORTIC bypass; with prosthetic valve other than homograft or stentless valve *33406 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with allograft valve (freehand) *33410 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with stentless tissue valve *33510 Coronary artery bypass, vein only; single coronary venous graft Cardiac/Open Heart 35572 Harvest of femoropopliteal vein, 1 segment, for vascular Cardiac/Open Heart reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in addition to code for primary procedure) CORONARY ARTERY BYPASS GRAFT (CABG), WITH ENDOSCOPIC VESSEL CORONARY GRAFTWENDOSCOPE HARVEST REPAIR/REPLACE MITRAL *33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart PROCUREMENT AND OR REPLACEMENT VALVE *33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with Cardiac/Open Heart prosthetic ring

Page 4 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service CORONARY ARTERY BYPASS GRAFT (CABG), WITH ENDOSCOPIC VESSEL CORONARY GRAFTWENDOSCOPE HARVEST REPAIR/REPLACE MITRAL *33427 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart PROCUREMENT AND MITRAL VALVE REPAIR OR REPLACEMENT VALVE radical reconstruction, with or without ring *33430 Replacement, mitral valve, with cardiopulmonary bypass Cardiac/Open Heart 33508 Endoscopy, surgical, including video-assisted harvest of vein(s) Cardiac/Open Heart for coronary artery bypass procedure (List separately in addition to code for primary procedure) *33510 Coronary artery bypass, vein only; single coronary venous graft Cardiac/Open Heart *33511 Coronary artery bypass, vein only; 2 coronary venous grafts Cardiac/Open Heart *33512 Coronary artery bypass, vein only; 3 coronary venous grafts Cardiac/Open Heart *33513 Coronary artery bypass, vein only; 4 coronary venous grafts Cardiac/Open Heart *33514 Coronary artery bypass, vein only; 5 coronary venous grafts Cardiac/Open Heart *33516 Coronary artery bypass, vein only; 6 or more coronary venous Cardiac/Open Heart grafts *33533 Coronary artery bypass, using arterial graft(s); single arterial Cardiac/Open Heart graft *33534 Coronary artery bypass, using arterial graft(s); 2 coronary Cardiac/Open Heart arterial grafts *33535 Coronary artery bypass, using arterial graft(s); 3 coronary Cardiac/Open Heart arterial grafts *33536 Coronary artery bypass, using arterial graft(s); 4 or more Cardiac/Open Heart coronary arterial grafts CORONARY ARTERY BYPASS GRAFT (CABG), WITH ENDOSCOPIC VESSEL CORONARY GRAFTS W ENDOSCOPIC HARVEST REPLACE MITRAL VALVE *33430 Replacement, mitral valve, with cardiopulmonary bypass Cardiac/Open Heart PROCUREMENT AND 33508 Endoscopy, surgical, including video-assisted harvest of vein(s) Cardiac/Open Heart for coronary artery bypass procedure (List separately in addition to code for primary procedure) *33510 Coronary artery bypass, vein only; single coronary venous graft Cardiac/Open Heart CORONARY ARTERY BYPASS GRAFT (CABG), WITH ENDOSCOPIC VESSEL CORONARY GRAFTS W ENDOSCOPIC HARVEST WREPAIR TRICUSPID VALVE *33463 Valvuloplasty, tricuspid valve; without ring insertion Cardiac/Open Heart PROCUREMENT AND TRICUSPID VALVE REPAIR *33464 Valvuloplasty, tricuspid valve; with ring insertion Cardiac/Open Heart 33508 Endoscopy, surgical, including video-assisted harvest of vein(s) Cardiac/Open Heart for coronary artery bypass procedure (List separately in addition to code for primary procedure) *33510 Coronary artery bypass, vein only; single coronary venous graft Cardiac/Open Heart *33511 Coronary artery bypass, vein only; 2 coronary venous grafts Cardiac/Open Heart *33512 Coronary artery bypass, vein only; 3 coronary venous grafts Cardiac/Open Heart *33513 Coronary artery bypass, vein only; 4 coronary venous grafts Cardiac/Open Heart *33514 Coronary artery bypass, vein only; 5 coronary venous grafts Cardiac/Open Heart *33516 Coronary artery bypass, vein only; 6 or more coronary venous Cardiac/Open Heart grafts *33533 Coronary artery bypass, using arterial graft(s); single arterial Cardiac/Open Heart graft *33534 Coronary artery bypass, using arterial graft(s); 2 coronary Cardiac/Open Heart arterial grafts *33535 Coronary artery bypass, using arterial graft(s); 3 coronary Cardiac/Open Heart arterial grafts

Page 5 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service CORONARY ARTERY BYPASS GRAFT (CABG), WITH ENDOSCOPIC VESSEL CORONARY GRAFTS W ENDOSCOPIC HARVEST WREPAIR TRICUSPID VALVE *33536 Coronary artery bypass, using arterial graft(s); 4 or more Cardiac/Open Heart PROCUREMENT AND TRICUSPID VALVE REPAIR coronary arterial grafts CORONARY ARTERY BYPASS GRAFT (CABG), WITH ENDOSCOPIC VESSEL CORONARY GRAFTS OFF PUMP W ENDOSCOPIC HARVEST 33508 Endoscopy, surgical, including video-assisted harvest of vein(s) Cardiac/Open Heart PROCUREMENT, WITHOUT CARDIOPULMONARY BYPASS for coronary artery bypass procedure (List separately in addition to code for primary procedure) *33510 Coronary artery bypass, vein only; single coronary venous graft Cardiac/Open Heart CORONARY GRAFTSW ENDOSCOPIC HARVEST W LESS SAPHENOUS Cardiac/Open Heart HARVEST CREATION, , SUBXIPHOID APPROACH, WITH DRAINAGE/BIOPSY PERICARDIAL WINDOW SUBXYPHOID APPROACH 32604 Thoracoscopy, diagnostic (separate procedure); pericardial sac, Cardiac/Open Heart, Thoracic BIOPSY OR DRAINAGE with biopsy *32659 Thoracoscopy, surgical; with creation of pericardial window or Cardiac/Open Heart, Thoracic partial resection of pericardial sac for drainage *33025 Creation of pericardial window or partial resection for drainage Cardiac/Open Heart, Thoracic CREATION, PERICARDIAL WINDOW, WITH BIOPSY OR DRAINAGE, AFTER DRAINAGE PERICARDIAL WINDOW POST CARDIAC SURGERY 32604 Thoracoscopy, diagnostic (separate procedure); pericardial sac, Cardiac/Open Heart CARDIAC SURGERY with biopsy *32659 Thoracoscopy, surgical; with creation of pericardial window or Cardiac/Open Heart partial resection of pericardial sac for drainage *33025 Creation of pericardial window or partial resection for drainage Cardiac/Open Heart CREATION, TRACHEOSTOMY TRACHEOSTOMY 31600 Tracheostomy, planned (separate procedure); Cardiac/Open Heart, Thoracic, General 31601 Tracheostomy, planned (separate procedure); younger than 2 Cardiac/Open Heart, Thoracic, years General 31603 Tracheostomy, emergency procedure; transtracheal Cardiac/Open Heart, Thoracic, General 31605 Tracheostomy, emergency procedure; cricothyroid membrane Cardiac/Open Heart, Thoracic, General 31610 Tracheostomy, fenestration procedure with skin flaps Cardiac/Open Heart, Thoracic, General DEBRIDEMENT, WOUND DEBRIDEMENT WOUND 11042 Debridement, subcutaneous tissue (includes epidermis and Plastics, Orthopedics, General, dermis, if performed); first 20 sq cm or less Gynecology, Podiatry, Pacemakers, Vascular, Colorectal, Neurosurgery, Thoracic, Cardiac/Open Heart, Urology 11043 Debridement, muscle and/or fascia (includes epidermis, Plastics, Orthopedics, General, dermis, and subcutaneous tissue, if performed); first 20 sq cm Gynecology, Podiatry, or less Pacemakers, Vascular, Colorectal, Neurosurgery, Thoracic, Cardiac/Open Heart, Urology 11044 Debridement, bone (includes epidermis, dermis, subcutaneous Plastics, Orthopedics, General, tissue, muscle and/or fascia, if performed); first 20 sq cm or Gynecology, Podiatry, less Pacemakers, Vascular, Colorectal, Neurosurgery, Thoracic, Cardiac/Open Heart, Urology

Page 6 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service DEBRIDEMENT, WOUND DEBRIDEMENT WOUND 11045 Debridement, subcutaneous tissue (includes epidermis and Plastics, Orthopedics, General, dermis, if performed); each additional 20 sq cm, or part Gynecology, Podiatry, thereof (List separately in addition to code for primary Pacemakers, Vascular, procedure) Colorectal, Neurosurgery, Thoracic, Cardiac/Open Heart, Urology 11046 Debridement, muscle and/or fascia (includes epidermis, Plastics, Orthopedics, General, dermis, and subcutaneous tissue, if performed); each Gynecology, Podiatry, additional 20 sq cm, or part thereof (List separately in addition Pacemakers, Vascular, to code for primary procedure) Colorectal, Neurosurgery, Thoracic, Cardiac/Open Heart, Urology 11047 Debridement, bone (includes epidermis, dermis, subcutaneous Plastics, Orthopedics, General, tissue, muscle and/or fascia, if performed); each additional 20 Gynecology, Podiatry, sq cm, or part thereof (List separately in addition to code for Pacemakers, Vascular, primary procedure) Colorectal, Neurosurgery, Thoracic, Cardiac/Open Heart, Urology 97597 Debridement (eg, high pressure waterjet with/without suction, Plastics, Orthopedics, General, sharp selective debridement with scissors, scalpel and forceps), Gynecology, Podiatry, open wound, (eg, fibrin, devitalized epidermis and/or dermis, Pacemakers, Vascular, exudate, debris, biofilm), including topical application(s), Colorectal, Neurosurgery, wound Thoracic, Cardiac/Open Heart, Urology 97598 Debridement (eg, high pressure waterjet with/without suction, Plastics, Orthopedics, General, sharp selective debridement with scissors, scalpel and forceps), Gynecology, Podiatry, open wound, (eg, fibrin, devitalized epidermis and/or dermis, Pacemakers, Vascular, exudate, debris, biofilm), including topical application(s), Colorectal, Neurosurgery, wound Thoracic, Cardiac/Open Heart, Urology 97602 Removal of devitalized tissue from wound(s), non-selective Plastics, Orthopedics, General, debridement, without (eg, wet-to-moist dressings, Gynecology, Podiatry, enzymatic, abrasion, larval therapy), including topical Pacemakers, Vascular, application(s), wound assessment, and instruction(s) for Colorectal, Neurosurgery, ongoing care, per sess Thoracic, Cardiac/Open Heart, Urology DEBRIDEMENT, WOUND, DEBRIDMENT/EXPLORATION STERNAL WOUND 11000 Debridement of extensive eczematous or infected skin; up to Cardiac/Open Heart 10% of body surface 11001 Debridement of extensive eczematous or infected skin; each Cardiac/Open Heart additional 10% of the body surface, or part thereof (list separately in addition to code for primary procedure) 11042 Debridement, subcutaneous tissue (includes epidermis and Cardiac/Open Heart dermis, if performed); first 20 sq cm or less 11043 Debridement, muscle and/or fascia (includes epidermis, Cardiac/Open Heart dermis, and subcutaneous tissue, if performed); first 20 sq cm or less

Page 7 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service DEBRIDEMENT, WOUND, STERNUM DEBRIDMENT/EXPLORATION STERNAL WOUND 11045 Debridement, subcutaneous tissue (includes epidermis and Cardiac/Open Heart dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) 11046 Debridement, muscle and/or fascia (includes epidermis, Cardiac/Open Heart dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) 11047 Debridement, bone (includes epidermis, dermis, subcutaneous Cardiac/Open Heart tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) *21627 Sternal debridement Cardiac/Open Heart *21750 Closure of separation with or without Cardiac/Open Heart debridement (separate procedure) 97597 Debridement (eg, high pressure waterjet with/without suction, Cardiac/Open Heart sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound 97598 Debridement (eg, high pressure waterjet with/without suction, Cardiac/Open Heart sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound 97602 Removal of devitalized tissue from wound(s), non-selective Cardiac/Open Heart debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per sess DECORTICATION, , THORACOSCOPIC THORACOSCOPY W PULMONARY DECORTICATION *32651 Thoracoscopy, surgical; with partial pulmonary decortication Cardiac/Open Heart, Thoracic *32652 Thoracoscopy, surgical; with total pulmonary decortication, Cardiac/Open Heart, Thoracic including intrapleural pneumonolysis ESOPHAGOGASTRECTOMY, COMBINED THORACOTOMY AND THORACOTOMY ESOPHAGECTOMY ESOPHAGOGASTRECTOMY XI ROBOTIC *43287 Esophagectomy, distal two-thirds, with laparoscopic Cardiac/Thoracic Robotics LAPAROSCOPIC ROBOT-ASSISTED ABDOMINAL APPROACHES, USING XI mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle a *43288 Esophagectomy, total or near total, with thoracoscopic Cardiac/Thoracic Robotics mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical phary ESOPHAGOMYOTOMY, ROBOT-ASSISTED, LAPAROSCOPIC, HELLER, USING MYOTOMY HELLER'S LAPAROSCOPY W XI ROBOTICS *43279 Laparoscopy, surgical, esophagomyotomy (Heller type), with General Robotics, XI fundoplasty, when performed Cardiac/Thoracic Robotics

Page 8 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service EVACUATION, HEMATOMA EVACUATION OF HEMATOMA Gynecology, Gynecology Oncology, General, Bariatric, Spine, Neurosurgery, Plastics, Cardiac/Open Heart, Thoracic, General Robotics, Gynecology Robotics, Urology, Urology Robotics, Vascular EXCISION, MASS, MEDIASTINUM, ROBOT-ASSISTED, USING XI RESECTION MEDIASTINAL MASS W XI ROBOTICS *32662 Thoracoscopy, surgical; with excision of mediastinal cyst, Cardiac/Thoracic Robotics tumor, or mass EXCISION, MYXOMA, CARDIAC , MINIMALLY INVASIVE, RIGHT THORACOTOMY RIGHT W HEARTPORT W REMOVAL ATRIAL MYXOMA *33120 Excision of intracardiac tumor, resection with cardiopulmonary Cardiac/Open Heart THORACOTOMY APPROACH, USING HEARTPORT TECHNIQUE, WITH TRANSESOPHAEGEAL ECHO bypass INTRAOPERATIVE TRANSESOPHAGEAL (TEE) 93355 Echocardiography, transesophageal (tee) for guidance of a Cardiac/Open Heart transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial ap EXCISION, RIB RESECTION RIB 21600 Excision of rib, partial Thoracic, Vascular, Cardiac/Open Heart *21615 Excision first and/or cervical rib; Thoracic, Vascular, Cardiac/Open Heart *21616 Excision first and/or cervical rib; with sympathectomy Thoracic, Vascular, Cardiac/Open Heart *32900 Resection of ribs, extrapleural, all stages Thoracic, Vascular, Cardiac/Open Heart INCISION AND DRAINAGE INCISION AND DRAINAGE General, Colorectal, Cardiac/Open Heart, Gynecology, Vascular INSERTION, CARDIAC PACEMAKER INSERTION PACEMAKER 33206 Insertion of new or replacement of permanent pacemaker Pacemakers, Cardiac/Open with transvenous electrode(s); atrial Heart 33207 Insertion of new or replacement of permanent pacemaker Pacemakers, Cardiac/Open with transvenous electrode(s); ventricular Heart 33208 Insertion of new or replacement of permanent pacemaker Pacemakers, Cardiac/Open with transvenous electrode(s); atrial and ventricular Heart 33214 Upgrade of implanted pacemaker system, conversion of single Pacemakers, Cardiac/Open chamber system to dual chamber system (includes removal of Heart previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator) 33216 Insertion of a single transvenous electrode, permanent Pacemakers, Cardiac/Open pacemaker or implantable defibrillator Heart 33217 Insertion of 2 transvenous electrodes, permanent pacemaker Pacemakers, Cardiac/Open or implantable defibrillator Heart 33221 Insertion of pacemaker pulse generator only; with existing Pacemakers, Cardiac/Open multiple leads Heart INSERTION, CARDIAC PACEMAKER, BIVENTRICULAR INSERTION OF BIVENTRICULAR PACEMAKER 33206 Insertion of new or replacement of permanent pacemaker Pacemakers, Cardiac/Open with transvenous electrode(s); atrial Heart 33207 Insertion of new or replacement of permanent pacemaker Pacemakers, Cardiac/Open with transvenous electrode(s); ventricular Heart

Page 9 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service INSERTION, CARDIAC PACEMAKER, BIVENTRICULAR INSERTION OF BIVENTRICULAR PACEMAKER 33208 Insertion of new or replacement of permanent pacemaker Pacemakers, Cardiac/Open with transvenous electrode(s); atrial and ventricular Heart 33212 Insertion of pacemaker pulse generator only; with existing Pacemakers, Cardiac/Open single lead Heart 33213 Insertion of pacemaker pulse generator only; with existing dual Pacemakers, Cardiac/Open leads Heart 33214 Upgrade of implanted pacemaker system, conversion of single Pacemakers, Cardiac/Open chamber system to dual chamber system (includes removal of Heart previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator) 33216 Insertion of a single transvenous electrode, permanent Pacemakers, Cardiac/Open pacemaker or implantable defibrillator Heart 33217 Insertion of 2 transvenous electrodes, permanent pacemaker Pacemakers, Cardiac/Open or implantable defibrillator Heart 33221 Insertion of pacemaker pulse generator only; with existing Pacemakers, Cardiac/Open multiple leads Heart INSERTION, CENTRAL VENOUS ACCESS DEVICE, TUNNELED INSERT CENTRAL VENOUS ACCESS DEVICE TUNNEL 36557 Insertion of tunneled centrally inserted central venous General, Thoracic, catheter, without subcutaneous port or pump; younger than 5 Cardiac/Open Heart years of age 36558 Insertion of tunneled centrally inserted central venous General, Thoracic, catheter, without subcutaneous port or pump; age 5 years or Cardiac/Open Heart older 36560 Insertion of tunneled centrally inserted central venous access General, Thoracic, device, with subcutaneous port; younger than 5 years of age Cardiac/Open Heart 36561 Insertion of tunneled centrally inserted central venous access General, Thoracic, device, with subcutaneous port; age 5 years or older Cardiac/Open Heart 36563 Insertion of tunneled centrally inserted central venous access General, Thoracic, device with subcutaneous pump Cardiac/Open Heart 36565 Insertion of tunneled centrally inserted central venous access General, Thoracic, device, requiring 2 catheters via 2 separate venous access Cardiac/Open Heart sites; without subcutaneous port or pump (eg, Tesio type catheter) 36566 Insertion of tunneled centrally inserted central venous access General, Thoracic, device, requiring 2 catheters via 2 separate venous access Cardiac/Open Heart sites; with subcutaneous port(s) INSERTION, EPICARDIAL ELECTRODE LEAD, THORACOTOMY APPROACH THORACOTOMY W PLACEMENT OF EPICARDIAL LEAD CARDIAC *33202 Insertion of epicardial electrode(s); open incision (eg, Cardiac/Open Heart thoracotomy, median sternotomy, subxiphoid approach) INSERTION, INTRA-AORTIC BALLOON PUMP INSERTION INTRA-AORTIC BALLOON *33967 Insertion of intra-aortic balloon assist device, percutaneous Cardiac/Open Heart, Cardiac, Cardiovascular *33970 Insertion of intra-aortic balloon assist device through the Cardiac/Open Heart, Cardiac, femoral artery, open approach Cardiovascular *33973 Insertion of intra-aortic balloon assist device through the Cardiac/Open Heart, Cardiac, ascending Cardiovascular INSERTION, PLEURX CATHETER SYSTEM, INSERTION PLEURX CATHETER 32550 Insertion of indwelling tunneled pleural catheter with cuff Cardiac/Open Heart, Thoracic LEFT HEART CATHETERIZATION W PERCUTANEOUS INTERVENTION W Cardiac/Open Heart STENT W TRANSAORTIC VALVE REPLACEMENT LEFT HEART CATHETERIZATION W PERCUTANEOUS INTERVENTION W Cardiac/Open Heart STENT W TRANSAPICAL AORTIC VALVE IMPLANT THORACIC Page 10 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service LEFT HEART CATHETERIZATION W PERCUTANEOUS INTERVENTION W Cardiac/Open Heart STENT W TRANSCATHETER AORTIC VALVE IMPLANT FEMORAL LOBECTOMY, LUNG, ROBOT-ASSISTED, THORACOSCOPIC, USING XI THORACOSCOPY LOBECTOMY W XI ROBOTICS *32663 Thoracoscopy, surgical; with lobectomy (single lobe) Cardiac/Thoracic Robotics MAZE PROCEDURE, MINIMALLY INVASIVE, USING , WITH THORACOTOMY RIGHT W CRYOABLATION W TRANSESOPHAGEAL ECHO *33254 Operative tissue ablation and reconstruction of atria, limited Cardiac/Open Heart TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) (eg, modified maze procedure) *33255 Operative tissue ablation and reconstruction of atria, extensive Cardiac/Open Heart (eg, maze procedure); without cardiopulmonary bypass 93355 Echocardiography, transesophageal (tee) for guidance of a Cardiac/Open Heart transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial ap MAZE PROCEDURE, MINIMALLY INVASIVE, WITH TRANSESOPHAGEAL THORACOTOMY MINI MAZE BILATERAL W *33254 Operative tissue ablation and reconstruction of atria, limited Cardiac/Open Heart ECHOCARDIOGRAPHY (TEE) W TRANSESOPHAEGEAL ECHO (eg, modified maze procedure) *33255 Operative tissue ablation and reconstruction of atria, extensive Cardiac/Open Heart (eg, maze procedure); without cardiopulmonary bypass 93355 Echocardiography, transesophageal (tee) for guidance of a Cardiac/Open Heart transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial ap MEDIAN STERNOTOMY COMPOSITE GRAFT Cardiac/Open Heart MEDIAN STERNOTOMY, WITH ATRIAL MYXOMA EXCISION MEDIANSTERNOTOMY EXCISION ATRIAL MYXOMA *33120 Excision of intracardiac tumor, resection with cardiopulmonary Cardiac/Open Heart bypass MEDIAN STERNOTOMY, WITH TRANSMYOCARDIAL LASER REVASCULARIZATION TRANSMYOCARDIAL WITH LASER *33140 Transmyocardial laser revascularization, by thoracotomy; Cardiac/Open Heart REVASCULARIZATION AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY MEDIANTERNOTOMY+TRANSESOPHAEGEAL ECHO (separate procedure) (TEE) 93318 Echocardiography, transesophageal (TEE) for monitoring Cardiac/Open Heart purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to t 93355 Echocardiography, transesophageal (tee) for guidance of a Cardiac/Open Heart transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial ap PERICARDIECTOMY *33030 Pericardiectomy, subtotal or complete; without Cardiac/Open Heart cardiopulmonary bypass *33031 Pericardiectomy, subtotal or complete; with cardiopulmonary Cardiac/Open Heart bypass PLICATION HEMIDIAPHRAGM,ROBOT-ASSISTED,THORACOSCOPIC,USING General Robotics, DA VINCI XI Cardiac/Thoracic Robotics RADIOFREQUENCY ABLATION ABLATION RADIOFREQUENCY BIPOLAR/UNIPOLAR 0404T Transcervical uterine fibroid(s) ablation with ultrasound Cardiac/Open Heart guidance, radiofrequency

Page 11 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service RADIOFREQUENCY ABLATION ABLATION RADIOFREQUENCY BIPOLAR/UNIPOLAR 32998 Ablation therapy for reduction or eradication of 1 or more Cardiac/Open Heart pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; radiofrequency 36475 Endovenous ablation therapy of incompetent vein, extremity, Cardiac/Open Heart inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated 36476 Endovenous ablation therapy of incompetent vein, extremity, Cardiac/Open Heart inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition t 41530 Submucosal ablation of the tongue base, radiofrequency, 1 or Cardiac/Open Heart more sites, per session 47382 Ablation, 1 or more liver tumor(s), percutaneous, Cardiac/Open Heart radiofrequency 50592 Ablation, 1 or more renal tumor(s), percutaneous, unilateral, Cardiac/Open Heart radiofrequency REMOVAL, CENTRAL VENOUS ACCESS DEVICE REMOVAL CENTRAL VENOUS ACCESS DEVICES 36589 Removal of tunneled central venous catheter, without General, Thoracic, Oncology, subcutaneous port or pump Cardiac/Open Heart 36590 Removal of tunneled central venous access device, with General, Thoracic, Oncology, subcutaneous port or pump, central or peripheral insertion Cardiac/Open Heart REMOVAL, INTRA-AORTIC BALLOON PUMP REMOVAL INTRA AORTIC BALLOON *33968 Removal of intra-aortic balloon assist device, percutaneous Cardiac/Open Heart, Cardiac, Cardiovascular *33971 Removal of intra-aortic balloon assist device including repair of Cardiac/Open Heart, Cardiac, femoral artery, with or without graft Cardiovascular *33974 Removal of intra-aortic balloon assist device from the Cardiac/Open Heart, Cardiac, ascending aorta, including repair of the ascending aorta, with Cardiovascular or without graft REMOVAL, STERNAL WIRE, WITH REWIRING IF INDICATED REWIRE/REMOVAL WIRE STERNAL WOUND 20650 Insertion of wire or pin with application of skeletal traction, Cardiac/Open Heart including removal (separate procedure) 20670 Removal of implant; superficial (eg, buried wire, pin or rod) Cardiac/Open Heart (separate procedure) 20680 Removal of implant; deep (eg, buried wire, pin, screw, metal Cardiac/Open Heart band, nail, rod or plate) *21750 Closure of median sternotomy separation with or without Cardiac/Open Heart debridement (separate procedure) REPAIR OR REPLACEMENT, MITRAL VALVE REPAIR/REPLACEMENT MITRAL VALVE *0345T Transcatheter mitral valve repair percutaneous approach via Cardiac/Open Heart the coronary sinus *33418 Transcatheter mitral valve repair, percutaneous approach, Cardiac/Open Heart including transseptal puncture when performed; initial prosthesis 33419 Transcatheter mitral valve repair, percutaneous approach, Cardiac/Open Heart including transseptal puncture when performed; additional prosthesis(es) during same session (list separately in addition to code for primary procedure) *33420 Valvotomy, mitral valve; closed heart Cardiac/Open Heart

Page 12 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service REPAIR OR REPLACEMENT, MITRAL VALVE REPAIR/REPLACEMENT MITRAL VALVE *33422 Valvotomy, mitral valve; open heart, with cardiopulmonary Cardiac/Open Heart bypass *33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart *33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with Cardiac/Open Heart prosthetic ring *33427 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart radical reconstruction, with or without ring *33430 Replacement, mitral valve, with cardiopulmonary bypass Cardiac/Open Heart 92987 Percutaneous balloon valvuloplasty; mitral valve Cardiac/Open Heart REPAIR OR REPLACEMENT, MITRAL VALVE, MINIMALLY INVASIVE, RIGHT REPAIR/REPLACE MITRAL VALVE HEARTPORT W RIGHT THORACOTOMY *33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart THORACOTOMY APPROACH, USING HEARTPORT TECHNIQUE *33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with Cardiac/Open Heart prosthetic ring REPAIR OR REPLACEMENT, TRICUSPID VALVE REPAIR/REPLACEMENT TRICUSPID VALVE *33463 Valvuloplasty, tricuspid valve; without ring insertion Cardiac/Open Heart *33464 Valvuloplasty, tricuspid valve; with ring insertion Cardiac/Open Heart *33465 Replacement, tricuspid valve, with cardiopulmonary bypass Cardiac/Open Heart REPAIR, ANEURYSM, AORTA, THORACIC, DESCENDING REPAIR THORACIC ANEURYSM (DESCENDING AORTA) *33875 Descending thoracic aorta graft, with or without bypass Cardiac/Open Heart *33877 Repair of thoracoabdominal aortic aneurysm with graft, with Cardiac/Open Heart or without cardiopulmonary bypass *33880 Endovascular repair of descending thoracic aorta (eg, Cardiac/Open Heart aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thora *33881 Endovascular repair of descending thoracic aorta (eg, Cardiac/Open Heart aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending t *33883 Placement of proximal extension prosthesis for endovascular Cardiac/Open Heart repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); initial extension *33884 Placement of proximal extension prosthesis for endovascular Cardiac/Open Heart repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); each additional proximal extension (List separatel REPAIR, ANEURYSM, CARDIAC REPAIR VENTRICULAR ANEURYSM *33542 Myocardial resection (eg, ventricular aneurysmectomy) Cardiac/Open Heart *33548 Surgical ventricular restoration procedure, includes prosthetic Cardiac/Open Heart patch, when performed (eg, ventricular remodeling, SVR, SAVER, Dor procedures) REPAIR, ATRIAL SEPTAL DEFECT REPAIR ATRIAL SEPTAL DEFECT *33641 Repair atrial septal defect, secundum, with cardiopulmonary Cardiac/Open Heart, bypass, with or without patch Cardiovascular 93580 Percutaneous transcatheter closure of congenital interatrial Cardiac/Open Heart, communication (ie, Fontan fenestration, atrial septal defect) Cardiovascular with implant

Page 13 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service REPAIR, ATRIAL SEPTAL DEFECT, ROBOT-ASSISTED, USING XI REPAIR ATRIAL SEPTAL DEFECT W XI ROBOTICS *33641 Repair atrial septal defect, secundum, with cardiopulmonary Cardiac/Thoracic Robotics bypass, with or without patch REPAIR, HERNIA, CHEST WALL REPAIR HERNIA LUNG *32800 Repair lung hernia through chest wall Cardiac/Open Heart, Thoracic REPAIR, MITRAL AND TRICUSPID VALVES REPAIR MITRAL VALVE W REPAIR TRICUSPID VALVE *33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart *33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with Cardiac/Open Heart prosthetic ring *33427 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart radical reconstruction, with or without ring *33463 Valvuloplasty, tricuspid valve; without ring insertion Cardiac/Open Heart *33464 Valvuloplasty, tricuspid valve; with ring insertion Cardiac/Open Heart REPAIR, MITRAL VALVE, ROBOT-ASSISTED, MINIMALLY INVASIVE, USING REPAIR MITRAL VALVE HEARTPORT W XI ROBOTICS *33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Thoracic Robotics HEARTPORT TECHNIQUE, USING XI *33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with Cardiac/Thoracic Robotics prosthetic ring REPAIR, MITRAL VALVE, TRANSCATHETER TRANSCATHETER MITRAL VALVE REPAIR *0345T Transcatheter mitral valve repair percutaneous approach via Cardiac/Open Heart, Cardiac, the coronary sinus Cardiovascular *33418 Transcatheter mitral valve repair, percutaneous approach, Cardiac/Open Heart, Cardiac, including transseptal puncture when performed; initial Cardiovascular prosthesis 33419 Transcatheter mitral valve repair, percutaneous approach, Cardiac/Open Heart, Cardiac, including transseptal puncture when performed; additional Cardiovascular prosthesis(es) during same session (list separately in addition to code for primary procedure) REPAIR, TRICUSPID VALVE REPAIR TRISCUPID VALVE *33463 Valvuloplasty, tricuspid valve; without ring insertion Cardiac/Open Heart *33464 Valvuloplasty, tricuspid valve; with ring insertion Cardiac/Open Heart REPAIR, VENTRICULAR SEPTAL DEFECT REPAIR VENTRICULAR SEPTAL DEFECT *33545 Repair of postinfarction ventricular septal defect, with or Cardiac/Open Heart without myocardial resection *33681 Closure of single ventricular septal defect, with or without Cardiac/Open Heart patch; 93581 Percutaneous transcatheter closure of a congenital ventricular Cardiac/Open Heart septal defect with implant REPLACEMENT, AORTA, ASCENDING REPLACEMENT ASCENDING AORTA *33860 Ascending aorta graft, with cardiopulmonary bypass, includes Cardiac/Open suspension, when performed *33863 Ascending aorta graft, with cardiopulmonary bypass, with Cardiac/Open Heart aortic root replacement using valved conduit and coronary reconstruction (eg, Bentall) *33864 Ascending aorta graft, with cardiopulmonary bypass with valve Cardiac/Open Heart suspension, with coronary reconstruction and valve-sparing aortic root remodeling (eg, David Procedure, Yacoub Procedure) REPLACEMENT, AORTIC VALVE *33361 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; percutaneous femoral artery approach *33362 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; open femoral artery approach *33363 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; open axillary artery approach

Page 14 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service REPLACEMENT, AORTIC VALVE REPLACEMENT AORTIC VALVE *33364 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; open iliac artery approach *33365 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy) *33366 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; transapical exposure (eg, left thoracotomy) *33405 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with prosthetic valve other than homograft or stentless valve *33406 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with allograft valve (freehand) *33410 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with stentless tissue valve *33411 Replacement, aortic valve; with aortic annulus enlargement, Cardiac/Open Heart noncoronary sinus *33412 Replacement, aortic valve; with transventricular aortic annulus Cardiac/Open Heart enlargement (Konno procedure) *33413 Replacement, aortic valve; by translocation of autologous Cardiac/Open Heart pulmonary valve with allograft replacement of pulmonary valve () REPLACEMENT, AORTIC VALVE AND TRICUSPID VALVE REPLACEMENT AORTIC VALVE W REPLACEMENT TRICUSPID VALVE *33405 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with prosthetic valve other than homograft or stentless valve *33406 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with allograft valve (freehand) *33410 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with stentless tissue valve *33465 Replacement, tricuspid valve, with cardiopulmonary bypass Cardiac/Open Heart REPLACEMENT, AORTIC VALVE, MINIMALLY INVASIVE REPLACEMENT AORTIC VALVE MINIMALLY INVASIVE *33361 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; percutaneous femoral artery approach *33362 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; open femoral artery approach *33363 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; open axillary artery approach *33364 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; open iliac artery approach *33365 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy) *33366 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; transapical exposure (eg, left thoracotomy) *33367 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (list separately in addition to code for primary procedure)

Page 15 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service REPLACEMENT, AORTIC VALVE, MINIMALLY INVASIVE REPLACEMENT AORTIC VALVE MINIMALLY INVASIVE *33368 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (list separately in addition to code for primary procedure *33369 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, ) (list separately in addition to code for primary procedure) REPLACEMENT, AORTIC VALVE, MINIMALLY INVASIVE, RIGHT REPLACEMENT AORTIC VALVE W HEARTPORT W THORACOTOMY RIGHT *33405 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart THORACOTOMY APPROACH, USING HEARTPORT TECHNIQUE bypass; with prosthetic valve other than homograft or stentless valve *33406 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with allograft valve (freehand) *33410 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with stentless tissue valve *33411 Replacement, aortic valve; with aortic annulus enlargement, Cardiac/Open Heart noncoronary sinus *33412 Replacement, aortic valve; with transventricular aortic annulus Cardiac/Open Heart enlargement (Konno procedure) *33413 Replacement, aortic valve; by translocation of autologous Cardiac/Open Heart pulmonary valve with allograft replacement of pulmonary valve (Ross procedure) REPLACEMENT, AORTIC VALVE, REPEAT REPLACEMENT AORTIC VALVE REDO *33361 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; percutaneous femoral artery approach *33362 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; open femoral artery approach *33363 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; open axillary artery approach *33364 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; open iliac artery approach *33365 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy) *33366 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; transapical exposure (eg, left thoracotomy) *33367 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (list separately in addition to code for primary procedure) *33368 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (list separately in addition to code for primary procedure

Page 16 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service REPLACEMENT, AORTIC VALVE, REPEAT REPLACEMENT AORTIC VALVE REDO *33369 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (list separately in addition to code for primary procedure) *33405 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with prosthetic valve other than homograft or stentless valve *33406 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with allograft valve (freehand) *33410 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with stentless tissue valve *33411 Replacement, aortic valve; with aortic annulus enlargement, Cardiac/Open Heart noncoronary sinus *33412 Replacement, aortic valve; with transventricular aortic annulus Cardiac/Open Heart enlargement (Konno procedure) *33413 Replacement, aortic valve; by translocation of autologous Cardiac/Open Heart pulmonary valve with allograft replacement of pulmonary valve (Ross procedure) *33530 Reoperation, coronary artery bypass procedure or valve Cardiac/Open Heart procedure, more than 1 month after original operation (List separately in addition to code for primary procedure) REPLACEMENT, AORTIC VALVE, TRANSAPICAL APPROACH TRANSAPICAL AORTIC VALVE IMPLANT THORACIC *33366 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart, Cardiac, prosthetic valve; transapical exposure (eg, left thoracotomy) Cardiovascular REPLACEMENT, AORTIC VALVE, TRANSCATHETER, FEMORAL APPROACH TRANSCATHETER AORTIC VALVE IMPLANT FEMORAL *33361 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart, Cardiac, prosthetic valve; percutaneous femoral artery approach Cardiovascular *33362 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart, Cardiac, prosthetic valve; open femoral artery approach Cardiovascular REPLACEMENT, AORTIC VALVE, TRANSCATHETER, SUBCLAVIAN ARTERY TRANSCATHETER AORTIC VALVE IMPLANT SUBCLAVIAN *33363 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart, Cardiac, APPROACH prosthetic valve; open axillary artery approach Cardiovascular REPLACEMENT, AORTIC VALVE, TRANSCATHETER, TRANSAORTIC TRANSAORTIC AORTIC VALVE REPLACEMENT *33365 Transcatheter aortic valve replacement (TAVR/TAVI) with Cardiac/Open Heart, Cardiac, APPROACH prosthetic valve; transaortic approach (eg, median Cardiovascular sternotomy, mediastinotomy) REPLACEMENT, AORTIC VALVE, WITH ASCENDING AORTA REPLACEMENT REPLACEMENT AORTIC VALVE W REPLACEMENT ASCENDING AORTA W *33863 Ascending aorta graft, with cardiopulmonary bypass, with Cardiac/Open Heart AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) TRANSESOPHAEGEAL ECHO aortic root replacement using valved conduit and coronary reconstruction (eg, Bentall) 93355 Echocardiography, transesophageal (tee) for guidance of a Cardiac/Open Heart transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial ap REPLACEMENT, AORTIC VALVE, WITH MITRAL VALVE REPAIR OR REPLACE /REPLACE MITRAL VALVE *33405 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart REPLACEMENT bypass; with prosthetic valve other than homograft or stentless valve *33406 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with allograft valve (freehand) *33410 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with stentless tissue valve

Page 17 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service REPLACEMENT, AORTIC VALVE, WITH MITRAL VALVE REPAIR OR REPLACE AORTIC VALVE REPAIR/REPLACE MITRAL VALVE *33411 Replacement, aortic valve; with aortic annulus enlargement, Cardiac/Open Heart REPLACEMENT noncoronary sinus *33412 Replacement, aortic valve; with transventricular aortic annulus Cardiac/Open Heart enlargement (Konno procedure) *33413 Replacement, aortic valve; by translocation of autologous Cardiac/Open Heart pulmonary valve with allograft replacement of pulmonary valve (Ross procedure) *33420 Valvotomy, mitral valve; closed heart Cardiac/Open Heart *33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart *33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with Cardiac/Open Heart prosthetic ring *33427 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart radical reconstruction, with or without ring *33430 Replacement, mitral valve, with cardiopulmonary bypass Cardiac/Open Heart 33440 Replacement, aortic valve; by translocation of autologous Cardiac/Open Heart pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (Ross-Konno procedure) REPLACEMENT, AORTIC VALVE, WITH MITRAL VALVE REPAIR OR REPAIR/REPLACE MITRAL REPLACE AORTIC REPAIR TRICUSPID VALVES *33405 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart REPLACEMENT AND TRICUSPID VALVE REPAIR OR REPLACEMENT bypass; with prosthetic valve other than homograft or stentless valve *33406 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with allograft valve (freehand) *33410 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with stentless tissue valve *33411 Replacement, aortic valve; with aortic annulus enlargement, Cardiac/Open Heart noncoronary sinus *33412 Replacement, aortic valve; with transventricular aortic annulus Cardiac/Open Heart enlargement (Konno procedure) *33413 Replacement, aortic valve; by translocation of autologous Cardiac/Open Heart pulmonary valve with allograft replacement of pulmonary valve (Ross procedure) *33420 Valvotomy, mitral valve; closed heart Cardiac/Open Heart *33422 Valvotomy, mitral valve; open heart, with cardiopulmonary Cardiac/Open Heart bypass *33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass; Cardiac/Open Heart *33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with Cardiac/Open Heart prosthetic ring *33430 Replacement, mitral valve, with cardiopulmonary bypass Cardiac/Open Heart 33440 Replacement, aortic valve; by translocation of autologous Cardiac/Open Heart pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (Ross-Konno procedure) *33463 Valvuloplasty, tricuspid valve; without ring insertion Cardiac/Open Heart *33464 Valvuloplasty, tricuspid valve; with ring insertion Cardiac/Open Heart

Page 18 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service REPLACEMENT, AORTIC VALVE, WITH MITRAL VALVE REPAIR OR REPAIR/REPLACE MITRAL REPLACE AORTIC REPAIR TRICUSPID VALVES *33468 Tricuspid valve repositioning and plication for Ebstein anomaly Cardiac/Open Heart REPLACEMENT AND TRICUSPID VALVE REPAIR OR REPLACEMENT REPLACEMENT, AORTIC VALVE, WITH TRICUSPID VALVE REPAIR REPLACEMENT AORTIC VALVE W REPAIR TRICUSPID VALVE *33405 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with prosthetic valve other than homograft or stentless valve *33406 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with allograft valve (freehand) *33410 Replacement, aortic valve, open, with cardiopulmonary Cardiac/Open Heart bypass; with stentless tissue valve *33411 Replacement, aortic valve; with aortic annulus enlargement, Cardiac/Open Heart noncoronary sinus *33412 Replacement, aortic valve; with transventricular aortic annulus Cardiac/Open Heart enlargement (Konno procedure) 33440 Replacement, aortic valve; by translocation of autologous Cardiac/Open Heart pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (Ross-Konno procedure) *33463 Valvuloplasty, tricuspid valve; without ring insertion Cardiac/Open Heart *33464 Valvuloplasty, tricuspid valve; with ring insertion Cardiac/Open Heart REPLACEMENT, MITRAL AND TRICUSPID VALVES REPLACEMENT MITRAL VALVE W REPLACEMENT TRICUSPID VALVE *33430 Replacement, mitral valve, with cardiopulmonary bypass Cardiac/Open Heart *33465 Replacement, tricuspid valve, with cardiopulmonary bypass Cardiac/Open Heart REPLACEMENT, MITRAL VALVE, REPEAT REPLACEMENT MITRAL VALVE REDO *33430 Replacement, mitral valve, with cardiopulmonary bypass Cardiac/Open Heart *33530 Reoperation, coronary artery bypass procedure or valve Cardiac/Open Heart procedure, more than 1 month after original operation (List separately in addition to code for primary procedure) REPLACEMENT, MITRAL VALVE, WITH TRICUSPID VALVE REPAIR OR REPLACEMENT MITRAL VALVE W REPAIR TRICUSPID VALVE *33430 Replacement, mitral valve, with cardiopulmonary bypass Cardiac/Open Heart REPLACEMENT *33463 Valvuloplasty, tricuspid valve; without ring insertion Cardiac/Open Heart *33464 Valvuloplasty, tricuspid valve; with ring insertion Cardiac/Open Heart REPLACEMENT, PULSE GENERATOR, IMPLANTABLE CARDIOVERTER REPLACE BIVENTRICULAR CARDIOVERTER DEFIBRILATOR GENERATOR 33225 Insertion of pacing electrode, cardiac venous system, for left Pacemakers, Cardiac/Open DEFIBRILLATOR (ICD), BIVENTRICULAR ventricular pacing, at time of insertion of implantable Heart defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (list separately in addition to code for primary pro 33263 Removal of implantable defibrillator pulse generator with Pacemakers, Cardiac/Open replacement of implantable defibrillator pulse generator; dual Heart lead system 33264 Removal of implantable defibrillator pulse generator with Pacemakers, Cardiac/Open replacement of implantable defibrillator pulse generator; Heart multiple lead system REWIRING, STERNUM, WITH CHEST WALL FLAP PROCEDURE REWIRE STERNAL WOUND W CHEST WALL FLAP 14000 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq Cardiac/Open Heart cm or less 14001 Adjacent tissue transfer or rearrangement, trunk; defect 10.1 Cardiac/Open Heart sq cm to 30.0 sq cm *21750 Closure of median sternotomy separation with or without Cardiac/Open Heart debridement (separate procedure)

Page 19 of 20 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - Cardiac/Open Heart Service New Name Old Name CPT Code Service SURGICAL PROCEDURE, REPEAT, AFTER OPEN HEART SURGERY, FOR EXPLORATION OPEN HEART BLEEDER *32120 Thoracotomy; for postoperative complications Cardiac/Open Heart HEMORRHAGE *35820 Exploration for postoperative hemorrhage, thrombosis or Cardiac/Open Heart ; chest 37244 Vascular embolization or occlusion, inclusive of all radiological Cardiac/Open Heart supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation THORACOSCOPY HYBRID PROCEDURE PUMP STDBY Cardiac/Open Heart THORACOSCOPY, VIDEO-ASSISTED, WITH BIOPSY THORACOSCOPY W BIOPSY VIDEO ASSIST 32604 Thoracoscopy, diagnostic (separate procedure); pericardial sac, Cardiac/Open Heart, Thoracic with biopsy 32606 Thoracoscopy, diagnostic (separate procedure); mediastinal Cardiac/Open Heart, Thoracic space, with biopsy 32607 Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) Cardiac/Open Heart, Thoracic (eg, wedge, incisional), unilateral 32608 Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or Cardiac/Open Heart, Thoracic mass(es) (eg, wedge, incisional), unilateral 32609 Thoracoscopy; with biopsy(ies) of pleura Cardiac/Open Heart, Thoracic THORACOSCOPY, WITH EPICARDIAL ELECTRODE LEAD INSERTION THORACOSCOPY W PLACEMENT EPICARDIAL LEAD CARDIAC *33203 Insertion of epicardial electrode(s); endoscopic approach (eg, Cardiac/Open Heart thoracoscopy, pericardioscopy) THORACOTOMY VIDEO ASSIST LOBECTOMY/WEDGE RESECTION W XI Cardiac/Thoracic Robotics ROBOTICS THORACOTOMY, WITH LOBECTOMY THORACOTOMY W LOBECTOMY *32480 Removal of lung, other than pneumonectomy; single lobe Cardiac/Open Heart, Thoracic (lobectomy) *32482 Removal of lung, other than pneumonectomy; 2 lobes Cardiac/Open Heart, Thoracic (bilobectomy) *32663 Thoracoscopy, surgical; with lobectomy (single lobe) Cardiac/Open Heart, Thoracic *32670 Thoracoscopy, surgical; with removal of two lobes Cardiac/Open Heart, Thoracic (bilobectomy) THYMECTOMY, ROBOT-ASSISTED, USING XI THYMECTOMY W XI ROBOTICS *32673 Thoracoscopy, surgical; with resection of thymus, unilateral or Cardiac/Thoracic Robotics bilateral TRANSCATHETER AORTIC VALVE REPLACEMENT () Cardiac/Open Heart, Cardiovascular TRANSCATHETER AORTIC VALVE REPLACEMENT CLINICAL TRIAL LOW RISK Cardiac, Cardiac/Open Heart, Cardiovascular WEDGE RESECTION, LUNG, ROBOT-ASSISTED, THORACOSCOPIC, USING XI THORACOSCOPY WEDGE RESECTION W XI ROBOTICS *32666 Thoracoscopy, surgical; with therapeutic wedge resection (eg, Cardiac/Thoracic Robotics mass, nodule), initial unilateral

Page 20 of 20 * Indicates Inpatient only CPT Code/Procedure