Summary & Overview
CPT 33617: Superior Vena Cava to Pulmonary Artery Connection
CPT code 33617 represents a specialized cardiothoracic surgical procedure that connects the superior vena cava directly to the pulmonary artery, bypassing the atrium and, when indicated, creating an intracardiac partition to direct flow. This operation is clinically significant for select congenital or acquired cardiac anomalies that impair normal venous return routing, and it has implications for surgical planning, inpatient resource use, and payer coverage determinations nationally. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose of CPT code 33617, typical settings where the procedure is performed, and the procedural scope it covers. The publication summarizes common billing modifiers associated with complex surgical services and highlights what is and is not available in the source input. The report also outlines areas where benchmarking and policy updates are typically relevant for high-acuity cardiac surgical codes, and orients clinicians, coders, and reimbursement analysts to the code’s clinical context and payer landscape. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 33617 describes a cardiac surgical procedure in which the provider directly connects the superior vena cava to the pulmonary artery to bypass the atrium. The surgeon may create a dividing wall within the atrium to optimize flow toward the superior vena cava opening.
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Service type: Open cardiac bypass procedure to reroute systemic venous return to the pulmonary circulation (surgical intracardiac rerouting).
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Typical site of service: Inpatient hospital operating room or cardiac surgery suite, often performed by cardiothoracic surgeons with cardiopulmonary bypass capability.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a child or young adult with congenital single-ventricle heart physiology, such as hypoplastic left heart syndrome or tricuspid atresia, who requires staged palliation. The patient is scheduled for a superior cavopulmonary anastomosis (classic bidirectional Glenn/Glenn-type procedure) where the surgeon directly connects the superior vena cava to the pulmonary artery to divert systemic venous blood from the upper body into the pulmonary circulation, bypassing the right atrium. Preoperative workflow includes cardiology evaluation, echocardiography, cardiac catheterization for hemodynamic assessment, anesthetic planning for pediatric cardiac surgery, and informed consent discussing risks (bleeding, arrhythmia, thrombosis). Intraoperative workflow involves median sternotomy or thoracotomy, cardiopulmonary bypass setup as indicated, mobilization and transection of the superior vena cava, and anastomosis to the right or left pulmonary artery. Postoperative workflow includes ICU monitoring, ventilatory support as needed, inotropic support, anticoagulation management, chest tube management, and staged planning for subsequent Fontan completion when appropriate. Typical sites of service are an inpatient tertiary pediatric cardiac surgery operating room and pediatric cardiac intensive care unit.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default — No modifier | Use when no other modifier applies and reporting standard procedure. |