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    v1.0.28
    OpenPayerBilling CodesSurgical Procedures on the Aortic ValveCPT cpt-33416-ventriculomyotomy-ventriculomyectomy-septal-myectomy
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    CPT 33416: Ventriculomyotomy/Ventriculomyectomy for Subaortic Stenosis

    Medicare pays $1912 on average nationally for this procedure.

    CPT code 33416 describes a surgical ventriculomyotomy/ventriculomyectomy — an incision into the muscular wall of the left ventricle with possible partial muscle removal to relieve obstruction from idiopathic hypertrophic subaortic stenosis; service type: open cardiac surgical procedure typically performed in an inpatient hospital operating room or cardiac surgery suite.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 56-year-old patient with symptomatic obstructive hypertrophic cardiomyopathy (idiopathic hypertrophic subaortic stenosis) presents with exertional dyspnea, syncope, and a harsh systolic murmur. Preoperative evaluation includes transthoracic and transesophageal echocardiography demonstrating significant left ventricular outflow tract (LVOT) obstruction from septal hypertrophy and systolic anterior motion of the mitral valve, plus coronary angiography to exclude obstructive coronary disease. The surgical team schedules a septal ventriculomyotomy/ventriculomyectomy (CPT 33416) via median sternotomy on cardiopulmonary bypass.

    The clinical workflow: the patient undergoes preoperative optimization by cardiology and anesthesia, informed consent discussing risks/benefits, intraoperative transesophageal echocardiography to guide resection, surgical incision into the hypertrophied interventricular septum with limited myectomy of obstructing muscle, hemostasis, and closure. Postoperative care includes monitoring in a cardiothoracic intensive care unit, serial echocardiography to confirm relief of LVOT gradient, rhythm surveillance for conduction disturbances (possible temporary pacing), pain control, and discharge planning with cardiology follow-up for functional assessment and long-term management.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    93451Right and left heart catheterization with coronary angiography when performed; includes measurement of intracardiac pressures and coronary visualization.Performed preoperatively to evaluate coronary anatomy and hemodynamics prior to CPT 33416.
    93312Transesophageal echocardiography, intraoperative, real-time with image documentation, including probe placement, interpretation and report.Used intraoperatively for guidance of septal resection and to assess LVOT gradient after CPT 33416.
    33210Insertion of temporary transvenous cardiac pacing electrode(s) with connection to external pacemaker.May be performed perioperatively when there is concern for conduction block or need for temporary pacing after septal myectomy.
    33405Repair of ventricular septal defect or other open heart repairs (example code for complex ventricular procedures) — note: used when concomitant intracardiac repairs are performed.Used if additional intracardiac repairs are required during the same operative session with CPT 33416.
    99223Initial hospital care, typically for major surgeries, high severity.Represents inpatient preoperative or postoperative evaluation and management associated with hospitalization for CPT 33416.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    171M00000XCase Manager/Care CoordinatorA person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other servic…
    323P00000XPsychiatric Residential Treatment FacilityA residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four ho…
    152WL0500XLow Vision Rehabilitation OptometristOptometrists who specialize in low-vision care having training to assess visual function, prescribe low-vision devices, develop treatment plans, and r…
    2085R0205XRadiological Physics PhysicianA radiological physicist deals with the diagnostic and therapeutic applications of roentgen rays, gamma rays from sealed sources, ultrasonic radiation…
    111NR0400XRehabilitation ChiropractorRehabilitation is the discipline focused on restoring a patient's functional abilities to pre-injury or pre-disease status. Functional abilities are d…

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    I21.3ST elevation (STEMI) myocardial infarction of unspecified site
    I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris
    I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
    I25.2Old myocardial infarction
    I26.99Other pulmonary embolism without acute cor pulmonale
    I34.0Nonrheumatic mitral (valve) insufficiency
    I34.1Nonrheumatic mitral (valve) prolapse
    I35.0Nonrheumatic aortic (valve) stenosis
    I35.1Nonrheumatic aortic (valve) insufficiency
    I35.9Nonrheumatic aortic valve disorder, unspecified

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    9 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    Related Codes

    CPT-33361-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-FEMORAL

    CPT 33361: Transfemoral Transcatheter Aortic Valve Implantation (TAVR)

    CPT-33362-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-OPEN-FEMORAL-APPROACH

    CPT 33362: Transcatheter Aortic Valve Replacement, Open Femoral Artery Approach

    CPT-33363-TAVR-TAVI-OPEN-AXILLARY-ARTERY-APPROACH

    CPT 33363: Transcatheter Aortic Valve Replacement, Open Axillary Approach

    CPT-33364-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-ILIAC-ARTERY-APPROACH

    CPT 33364: Transcatheter Aortic Valve Replacement, Open Iliac Approach

    CPT-33365-TRANSAORTIC-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-TAVR

    CPT 33365: Transaortic Transcatheter Aortic Valve Replacement

    CPT-33366-TRANSAPICAL-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT-TAVR-TAVI

    CPT 33366: Transapical Transcatheter Aortic Valve Replacement

    CPT-33367-CPB-DURING-TRANSCATHETER-AORTIC-VALVE-REPLACEMENT

    CPT 33367: Cardiopulmonary Bypass for Percutaneous Cannulation in TAVI/TAVR

    CPT-33368-CARDIOPULMONARY-BYPASS-DURING-TAVI-TAVR-OPEN-PERIPHERAL-CANNULATION

    CPT 33368: Cardiopulmonary Bypass for TAVI/TAVR with Open Peripheral Cannulation

    CPT-33369-CPB-CENTRAL-CANNULATION-DURING-TAVR

    CPT 33369: Cardiopulmonary Bypass for TAVI/TAVR with Central Cannulation

    CPT-33370-CEREBRAL-EMBOLIC-PROTECTION-TAVR

    CPT 33370: Cerebral Embolic Protection Placement During TAVR

    Showing 1–10 of 23

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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