Summary & Overview
CPT 33413: Ross Procedure — Aortic Valve Replacement with Pulmonary Autograft
CPT code 33413 identifies the Ross procedure, an autograft cardiac surgery that replaces a diseased aortic valve with the patient’s pulmonary valve to treat aortic stenosis or regurgitation. Nationally, this is a specialized open-heart operation performed by cardiothoracic surgeons and typically delivered in hospital operating rooms with inpatient recovery. The procedure carries surgical complexity and long-term clinical implications for valve durability and need for future interventions.
Key payers in a national review include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, plus what to expect in payer coverage practices, commonly reported modifiers, and related billing considerations. The publication highlights benchmarks and policy-relevant points affecting reimbursement and utilization for complex cardiac valve surgery, along with coding guidance and common documentation themes required for medical necessity and operative reporting.
This summary is intended for revenue cycle professionals, clinical billing staff, and policy analysts seeking authoritative, nationwide context on coding, payer engagement, and administrative aspects tied to the Ross procedure.
Billing Code Overview
CPT code 33413 describes the Ross procedure, a cardiac surgery in which the provider replaces the diseased aortic valve with the patient’s pulmonary valve. The operation treats aortic valve stenosis or regurgitation and involves autograft transfer of the pulmonary valve to the aortic position with reconstruction of the right ventricular outflow tract.
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Service type: Cardiac valve replacement surgery
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Typical site of service: Hospital operating room or inpatient cardiac surgical unit
Clinical & Coding Specifications
Clinical Context
A 45-year-old male with symptomatic aortic valve disease (severe aortic stenosis with bicuspid valve and mixed aortic regurgitation) is evaluated by a cardiothoracic surgery team after progressive exertional dyspnea, syncope episodes, and echocardiographic confirmation of severe valve dysfunction. Preoperative workup includes transthoracic and transesophageal echocardiography, coronary angiography to assess for concomitant coronary artery disease, routine labs, chest radiography, and anesthesia evaluation. The patient is scheduled for the Ross procedure (33413) during which the surgeon replaces the diseased aortic valve with the patient’s pulmonary autograft and reconstructs the right ventricular outflow tract with a homograft or prosthetic conduit. Intraoperative transesophageal echocardiography is used to confirm valve function, and the patient is transferred postoperatively to a cardiac intensive care unit for hemodynamic monitoring, ventilator weaning, anticoagulation management as indicated, and physical rehabilitation. Typical perioperative documentation includes indication for surgery, informed consent, intraoperative findings, valves and conduits used, bypass and cross-clamp times, and immediate postoperative status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the procedure. |