Summary & Overview
CPT 33463: Surgical Repair of Tricuspid Valve for Regurgitation
CPT code 33463 represents surgical repair of the tricuspid valve to correct tricuspid valve regurgitation, a clinically significant intervention to restore valve function and improve cardiac hemodynamics. Nationally, procedures to repair the tricuspid valve are important for patients with symptomatic regurgitation or functional tricuspid disease associated with other cardiac conditions. Coverage and payment for this inpatient cardiac surgery affect hospital resource allocation, care pathways, and post-operative management.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of where CPT code 33463 is used clinically, typical sites of service, and the broader clinical context for tricuspid valve repair. The publication presents benchmarking and payment context where available, highlights relevant policy updates affecting cardiac surgical services, and summarizes coding considerations tied to this specific CPT code. Clinical implications for care teams and hospital administrators are outlined, focusing on procedure intensity, inpatient care requirements, and alignment with cardiac surgery service lines.
Data not available in the input is noted where applicable, and readers will gain a clear, national-level briefing on CPT code 33463 and its role in surgical management of tricuspid valve regurgitation.
Billing Code Overview
CPT code 33463 describes a surgical repair of the tricuspid valve performed to correct tricuspid valve regurgitation. The procedure involves operative techniques to reconstruct or repair the native tricuspid valve apparatus to restore valve competence and reduce regurgitant flow.
Service Type: Cardiac surgery / Valvular repair
Typical Site of Service: Inpatient hospital setting or cardiac surgical center, where open or minimally invasive cardiac surgical procedures are performed under general anesthesia.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old male with progressive exertional dyspnea, peripheral edema, and jugular venous distension. Transthoracic and transesophageal echocardiography demonstrate severe tricuspid regurgitation with annular dilation and right ventricular volume overload. The patient has refractory symptoms despite optimized medical therapy (diuretics and afterload management) and is referred for surgical tricuspid valve repair. Preoperative workup includes coronary angiography, right heart catheterization, laboratory studies, and CT imaging as indicated. The procedure is performed in an inpatient hospital operating room with general endotracheal anesthesia and cardiopulmonary bypass. Postoperative care includes ICU monitoring, hemodynamic optimization, rhythm surveillance, and transthoracic echo before discharge. Typical payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier / standard reporting | Use for routine reporting when no special circumstances apply |
11 | Normal service | Use when the service is the usual, standalone service and not altered |