Summary & Overview
CPT 33464: Tricuspid Valvuloplasty with Ring Insertion
CPT code 33464 represents tricuspid valvuloplasty with ring insertion, a cardiac surgical procedure used to repair the tricuspid valve and treat tricuspid regurgitation. This code captures a valve repair approach that preserves native valve tissue while restoring annular geometry with an implanted ring. Nationally, procedures addressing tricuspid disease are gaining attention because of rising recognition of tricuspid regurgitation’s impact on morbidity and the expanding role of both surgical and transcatheter therapies.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the service type represented by the code. The publication outlines what stakeholders can expect in related content: payer coverage patterns and benchmarks where available, policy and coding guidance updates affecting surgical valve repair, and clinical considerations that inform coding and billing for tricuspid valve procedures. Where specific input data are missing, the text notes the absence of those elements.
This summary is intended for a national audience of clinicians, coding professionals, and policy analysts seeking a clear description of the procedure behind CPT code 33464 and the topics addressed in the full publication.
Billing Code Overview
CPT code 33464 describes tricuspid valvuloplasty with ring insertion, a surgical repair of the tricuspid valve performed to correct tricuspid regurgitation. The procedure involves reconstructing the native tricuspid valve and placing an annular ring to restore leaflet coaptation and valve competence.
Service type: Cardiac surgical valve repair (tricuspid)
Typical site of service: Inpatient or hospital-based operating room
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old with symptomatic tricuspid regurgitation presenting with progressive exertional dyspnea, peripheral edema, and signs of right-sided heart failure despite medical therapy. Diagnostic workup includes transthoracic and transesophageal echocardiography confirming severe tricuspid annular dilatation with leaflet tethering and significant regurgitant jet. The patient is evaluated by a cardiothoracic surgeon and a multidisciplinary heart team; preoperative testing includes right heart catheterization, routine labs, chest imaging, and optimization of volume status.
The operative workflow for 33464 (tricuspid valvuloplasty with ring insertion) typically involves general endotracheal anesthesia, median sternotomy or right thoracotomy exposure, cardiopulmonary bypass, and cardioplegic arrest or beating-heart technique per surgeon preference. The annulus is sized and a prosthetic annuloplasty ring is implanted to restore leaflet coaptation, often with concomitant leaflet repair techniques. Intraoperative transesophageal echocardiography confirms valve competence before weaning from bypass. Postoperative care includes ICU monitoring, hemodynamic support as needed, rhythm surveillance, anticoagulation planning if indicated, and echocardiographic follow-up to document repair durability.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier |