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CPT 33476: Right Ventricular Resection for Infundibular Stenosis

CPT code 33476 designates a surgical right ventricular resection with removal of obstructive fibrous bands in the infundibulum and, when necessary, commissurotomy of valve leaflet junctions to treat infundibular stenosis. This code captures a specialized open cardiac procedure used to relieve right ventricular outflow tract obstruction and is important for tracking utilization, clinical outcomes, and resource needs for congenital or acquired obstructive lesions. Nationally, this procedure is relevant to tertiary care centers and pediatric and adult cardiac surgery programs.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, benchmarks where available, coding context, and considerations relevant to billing and coverage policy. The publication provides an overview of typical sites of service and service type, identifies common modifiers and related administrative details when available, and summarizes clinical indications tied to the code.

The content is intended to inform coding professionals, revenue cycle teams, and policy analysts about the clinical and billing identity of CPT code 33476, how it is used in surgical practice, and the payer landscape that commonly processes claims for this procedure. Data not available in the input will be noted where applicable.

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Billing Code Overview

CPT code 33476 describes a surgical procedure in which the provider performs a right ventricular resection to remove obstructive fibrous bands in the infundibulum and, when needed, performs a commissurotomy by incising the junctions of the valve leaflets. The procedure is intended to treat infundibular stenosis, a cause of right ventricular outflow tract obstruction.

Service Type: Cardiac surgical procedure (open or surgical repair) involving the right ventricular outflow tract

Typical Site of Service: Inpatient hospital operating room / cardiac surgery suite, given the invasive nature of the resection and commissurotomy and the need for intraoperative monitoring and postoperative intensive care.

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CPT 33476: Right Ventricular Resection for Infundibular Stenosis

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Billing Code Overview

Service Type: Cardiac surgical procedure (open or surgical repair) involving the right ventricular outflow tract

Clinical & Coding Specifications

Clinical Context

A typical patient is an adolescent or young adult with symptomatic right ventricular outflow tract (infundibular) obstruction due to hypertrophic muscular bands or congenital infundibular stenosis. Presentation often includes exertional dyspnea, syncope, chest pain, or decreased exercise tolerance and may follow evaluation for congenital heart disease such as tetralogy of Fallot or isolated infundibular stenosis. Diagnostic workup includes transthoracic and transesophageal echocardiography to define the level and severity of obstruction, ECG, chest radiograph, and cardiac catheterization when hemodynamic assessment is needed.

The clinical workflow: preoperative evaluation by pediatric or adult congenital cardiology and cardiothoracic surgery; informed consent and perioperative anesthetic assessment; intraoperative transesophageal echocardiography for localization of infundibular bands; median sternotomy or appropriate surgical approach; right ventricular resection of obstructive fibrous/muscular bands with or without commissurotomy of pulmonary valve leaflets as indicated; intraoperative assessment of residual gradient and valve competence; postoperative ICU monitoring, analgesia, and serial echocardiography prior to discharge. Typical site of service is an inpatient hospital operating room with postoperative care in a cardiac intensive care unit or step-down unit.

Coding Specifications

Modifier	Description	When to Use
`62`	Two surgeons	When two surgeons work together as primary surgeons to perform the resection in complex anatomy.
`63`	Procedure performed on infants less than 4 kg	When patient weight criteria for `63` are met during neonatal/infant procedures.
`51`	Multiple procedures	When additional unrelated CPT-coded cardiac procedures are performed during the same operative session.
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances.
`22`	Increased procedural services	For unusually complex or prolonged resections requiring significantly greater work.
`26`	Professional component	If reporting a separately payable professional interpretation component (rare for operative CPT but applicable to associated diagnostic testing).
`23`	Unusual anesthesia — patient condition	When general anesthesia is contraindicated and anesthesia documentation supports unusually risky condition.
`78`	Return to OR for related procedure during global period	When the patient returns to the OR for a related procedure during the postoperative global period.
`79`	Unrelated procedure or service by same physician during global period	When an unrelated procedure is performed by the same surgeon during the global period.
`63`	(duplicate removed)	(See above)

Taxonomy Code	Specialty	Notes
207K00000X	Cardiothoracic Surgery	Primary specialty performing infundibular resection and commissurotomy.
207L00000X	Pediatric Cardiac Surgery	Pediatric cardiac surgeons for congenital cases in children and adolescents.
207RC0000X	Cardiovascular Disease (Adult Congenital)	Adult congenital heart disease specialists involved in pre/postoperative management.
208000000X	General Surgery (Cardiac-trained)	Cardiac-trained general surgeons or cardiothoracic teams in some institutions.
207RG0300X	Cardiothoracic Surgery — Neonatal	Surgeons with neonatal cardiac surgery expertise for infant cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q21.3`	Tetralogy of Fallot	Classic congenital lesion that often includes infundibular stenosis requiring RVOT resection as part of repair.
`I27.2`	Other secondary pulmonary hypertension	Elevated pulmonary pressures can result from or be associated with RVOT obstruction and influence surgical planning.
`Q22.1`	Congenital pulmonary valve stenosis	When commissurotomy of pulmonary valve leaflets is required in addition to infundibular resection.
`I34.1`	Nonrheumatic mitral (valve) insufficiency	Included as a potential concurrent valvular lesion to evaluate; may necessitate concurrent procedures.
`R06.02`	Shortness of breath, secondarily specified	Symptom code often present leading to diagnostics that uncover infundibular obstruction.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93451`	Right heart catheterization including measurement(s) of oxygen content and cardiac output when performed	Performed preoperatively for hemodynamic assessment of right ventricular outflow tract gradients when invasive measurement is needed.
`93312`	Transesophageal echocardiography, intraoperative	Intraoperative TEE used to localize infundibular obstruction and assess resection results.
`33405`	Repair of Tetralogy of Fallot; with patch and/or RVOT reconstruction (example code for related open repair)	Performed when infundibular resection is part of a more extensive repair for tetralogy of Fallot.
`99238`	Hospital discharge day management; more than 30 minutes	Common postoperative discharge billing for complex inpatient stays following this procedure.
`93568`	Intravascular echocardiography during catheterization (when applicable)	Used selectively during diagnostic catheterization to better define RVOT anatomy prior to surgical planning.

CPT 33474: Pulmonary Valve Incision (Valvotomy) on Cardiopulmonary Bypass

CPT-33475-PULMONARY-VALVE-REPLACEMENT

CPT 33475: Pulmonary Valve Replacement

CPT-33477-PERCUTANEOUS-PULMONARY-VALVE-IMPLANTATION

CPT 33477: Percutaneous Pulmonary Valve Implantation

CPT-33478-VENTRICULAR-OUTFLOW-TRACT-ENLARGEMENT-WITH-GRAFT

CPT 33478: Ventricular Outflow Tract Enlargement with Graft

Frequently Asked Questions

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`62`	Two surgeons	When two surgeons work together as primary surgeons to perform the resection in complex anatomy.
`63`	Procedure performed on infants less than 4 kg	When patient weight criteria for `63` are met during neonatal/infant procedures.
`51`	Multiple procedures	When additional unrelated CPT-coded cardiac procedures are performed during the same operative session.
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances.
`22`	Increased procedural services	For unusually complex or prolonged resections requiring significantly greater work.
`26`	Professional component	If reporting a separately payable professional interpretation component (rare for operative CPT but applicable to associated diagnostic testing).
`23`	Unusual anesthesia — patient condition	When general anesthesia is contraindicated and anesthesia documentation supports unusually risky condition.
`78`	Return to OR for related procedure during global period	When the patient returns to the OR for a related procedure during the postoperative global period.
`79`	Unrelated procedure or service by same physician during global period	When an unrelated procedure is performed by the same surgeon during the global period.
`63`	(duplicate removed)	(See above)

Taxonomy Code	Specialty	Notes
207K00000X	Cardiothoracic Surgery	Primary specialty performing infundibular resection and commissurotomy.
207L00000X	Pediatric Cardiac Surgery	Pediatric cardiac surgeons for congenital cases in children and adolescents.
207RC0000X	Cardiovascular Disease (Adult Congenital)	Adult congenital heart disease specialists involved in pre/postoperative management.
208000000X	General Surgery (Cardiac-trained)	Cardiac-trained general surgeons or cardiothoracic teams in some institutions.
207RG0300X	Cardiothoracic Surgery — Neonatal	Surgeons with neonatal cardiac surgery expertise for infant cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q21.3`	Tetralogy of Fallot	Classic congenital lesion that often includes infundibular stenosis requiring RVOT resection as part of repair.
`I27.2`	Other secondary pulmonary hypertension	Elevated pulmonary pressures can result from or be associated with RVOT obstruction and influence surgical planning.
`Q22.1`	Congenital pulmonary valve stenosis	When commissurotomy of pulmonary valve leaflets is required in addition to infundibular resection.
`I34.1`	Nonrheumatic mitral (valve) insufficiency	Included as a potential concurrent valvular lesion to evaluate; may necessitate concurrent procedures.
`R06.02`	Shortness of breath, secondarily specified	Symptom code often present leading to diagnostics that uncover infundibular obstruction.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93451`	Right heart catheterization including measurement(s) of oxygen content and cardiac output when performed	Performed preoperatively for hemodynamic assessment of right ventricular outflow tract gradients when invasive measurement is needed.
`93312`	Transesophageal echocardiography, intraoperative	Intraoperative TEE used to localize infundibular obstruction and assess resection results.
`33405`	Repair of Tetralogy of Fallot; with patch and/or RVOT reconstruction (example code for related open repair)	Performed when infundibular resection is part of a more extensive repair for tetralogy of Fallot.
`99238`	Hospital discharge day management; more than 30 minutes	Common postoperative discharge billing for complex inpatient stays following this procedure.
`93568`	Intravascular echocardiography during catheterization (when applicable)	Used selectively during diagnostic catheterization to better define RVOT anatomy prior to surgical planning.

CPT 33474: Pulmonary Valve Incision (Valvotomy) on Cardiopulmonary Bypass

CPT-33475-PULMONARY-VALVE-REPLACEMENT

CPT 33475: Pulmonary Valve Replacement

CPT-33477-PERCUTANEOUS-PULMONARY-VALVE-IMPLANTATION

CPT 33477: Percutaneous Pulmonary Valve Implantation

CPT-33478-VENTRICULAR-OUTFLOW-TRACT-ENLARGEMENT-WITH-GRAFT

CPT 33478: Ventricular Outflow Tract Enlargement with Graft

Frequently Asked Questions

References

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.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.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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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 33476: Right Ventricular Resection for Infundibular Stenosis

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Billing Code Overview

OpenPayer

CPT 33476: Right Ventricular Resection for Infundibular Stenosis

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 33476: Right Ventricular Resection for Infundibular Stenosis

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Billing Code Overview

CPT 33476: Right Ventricular Resection for Infundibular Stenosis

Sign up for cpt 33476 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What exactly does CPT 33476 represent and where is it typically performed?

Which modifiers are commonly applicable to CPT 33476 and when should they be considered?

What other CPT codes are commonly associated with the clinical workflow for this procedure?

Which clinical indications and preoperative diagnostics are associated with CPT 33476?

Which specialties or taxonomy codes are most relevant to billing and credentialing for CPT 33476?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What exactly does CPT 33476 represent and where is it typically performed?

Which modifiers are commonly applicable to CPT 33476 and when should they be considered?

What other CPT codes are commonly associated with the clinical workflow for this procedure?

Which clinical indications and preoperative diagnostics are associated with CPT 33476?

Which specialties or taxonomy codes are most relevant to billing and credentialing for CPT 33476?

References