Summary & Overview
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.
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.
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. |