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CPT 33620: Bilateral Pulmonary Artery Banding to Reduce Left-to-Right Shunt

CPT code 33620 denotes bilateral pulmonary artery banding, a cardiothoracic surgical procedure that places bands around the right and left pulmonary arteries to reduce left-to-right blood flow and prevent or relieve congestive heart failure and pulmonary hypertension. Nationally, this code is relevant for pediatric and congenital cardiac surgical programs involved in staged repair strategies and for payers managing high-cost inpatient surgical care. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn the clinical context for use of CPT code 33620, typical sites of service, and how the procedure fits into staged interventions for congenital heart disease. The publication provides benchmarks and utilization context where available, summarizes payer coverage patterns and common billing practices, and highlights policy and coding considerations relevant to hospital and surgical billing teams. Data not available in the input will be noted where applicable, and clinical context is provided to support accurate coding and claims submission for this inpatient surgical service.

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Billing Code Overview

CPT code 33620 describes a surgical procedure in which the provider places a band, typically of umbilical tape, around both the right and left pulmonary arteries to reduce left-to-right shunting. The objective of the procedure is to relieve or prevent congestive heart failure and pulmonary hypertension by constricting pulmonary blood flow. This operation is typically performed as part of staged surgical management for congenital cardiac lesions that produce excessive pulmonary blood flow.

Service type: Surgical cardiothoracic procedure to reduce pulmonary blood flow
Typical site of service: Inpatient surgical setting, typically performed in an operating room under cardiothoracic surgical care

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CPT 33620: Bilateral Pulmonary Artery Banding to Reduce Left-to-Right Shunt

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Billing Code Overview

Service type: Surgical cardiothoracic procedure to reduce pulmonary blood flow
Typical site of service: Inpatient surgical setting, typically performed in an operating room under cardiothoracic surgical care

Clinical & Coding Specifications

Clinical Context

A typical patient is an infant or young child with a significant congenital cardiac shunt (for example, large ventricular septal defect or patent ductus arteriosus) producing symptomatic left-to-right pulmonary overcirculation, failure to thrive, recurrent respiratory infections, or early signs of pulmonary hypertension and congestive heart failure. The cardiothoracic surgical team evaluates hemodynamics via echocardiography and cardiac catheterization; when definitive repair is deferred or staged, the surgeon performs bilateral pulmonary artery banding to reduce pulmonary blood flow, protect the pulmonary vasculature, and stabilize heart failure. The workflow includes preoperative assessment (imaging, labs, anesthesia evaluation), operative placement of umbilical tape bands around the right and left pulmonary arteries under general anesthesia with median sternotomy or thoracotomy exposure, intraoperative hemodynamic monitoring and adjustment of band tightness, and postoperative intensive care monitoring with serial echocardiography and potential later staged definitive repair.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — standard reporting	Use when no additional modifier applies and service is billed routinely
`11`	Provider's usual and customary service	Use when the procedure is performed as the usual service by the billing provider
`22`	Increased procedural service	Use when the procedure required substantially greater work than typical (document justification)
`23`	Unusual anesthesia — medically necessary	Use when general anesthesia is contraindicated and unusual anesthesia circumstances occur (document)
`62`	Two surgeons	Use when two surgeons with distinct skills actively participate in the procedure
`63`	Procedure performed on infants less than 4 kg	Use when special infant weight-based reporting applies (document weight)
`73`	Discontinued outpatient procedure prior to anesthesia	Use when planned outpatient procedure is terminated before anesthesia is given
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned
`53`	Discontinued procedure	Use when the procedure is terminated after anesthesia induction for patient safety
`78`	Return to operating room for related procedure during postoperative period	Use when patient returns to OR for a related complication in the global period
`80`	Assistant surgeon	Use when an assistant surgeon is required and documented
`81`	Minimum assistant surgeon	Use when minimal assistance is provided and meets payer criteria
`26`	Professional component	Rare for a surgical procedure; use when only professional component is billed distinct from facility
`51`	Multiple procedures	Use when additional distinct procedures are performed during the same operative session (list separately)

Taxonomy Code	Specialty	Notes
208100000X	Cardiothoracic Surgery	Primary specialty performing pulmonary artery banding
207P00000X	Pediatric Cardiac Surgery	Subspecialty for neonates and infants with congenital heart disease
207L00000X	Pediatric Surgery	Often involved in congenital thoracic procedures for infants
207Q00000X	Thoracic Surgery	May perform when approach is thoracotomy in older children
2080S0122X	Cardiac Surgery Critical Care	Involved in perioperative management and ICU care

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q21.0`	Ventricular septal defect	Large VSDs cause left-to-right shunt leading to pulmonary overcirculation managed initially by banding
`Q25.0`	Patent ductus arteriosus	Significant PDA with excessive pulmonary blood flow may be temporized with pulmonary artery banding in select infants
`Q21.2`	Atrioventricular septal defect	AV septal defects can produce high pulmonary flow and benefit from staged banding prior to complete repair
`Q21.1`	Atrial septal defect	Large defects with symptomatic overload in infancy may be part of complex physiology leading to banding decisions
`I50.1`	Left ventricular failure	Congestive heart failure resulting from volume overload is an indication to reduce pulmonary flow with banding
`I27.0`	Primary pulmonary hypertension	Banding may be performed to prevent progression of pulmonary vascular disease in certain congenital shunts
`P28.5`	Pulmonary hemorrhage originating in the perinatal period	Severe pulmonary overcirculation and respiratory compromise in neonates may prompt temporizing banding
`Z95.2`	Presence of prosthetic heart valve	Relevant in postoperative staged care or complex reoperations where pulmonary flow control may be required

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93451`	Right and left heart catheterization including intraprocedural congenital heart disease interventions	Used preoperatively to assess hemodynamics and pulmonary vascular resistance before banding
`93306`	Echocardiography, transthoracic, complete, real-time imaging	Used for diagnostic assessment and postoperative monitoring of band effect
`33405`	Repair of ventricular septal defect (VSD), closure; primary	Represents a staged definitive repair often performed after initial pulmonary artery banding in infants
`99291`	Critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 minutes	Used for postoperative ICU management of infants after banding when critical care time is documented
`94002`	Ventilation assist and management, initiation of pressure or volume preset ventilator for acute respiratory failure; hospital inpatient/observation	May be reported when postoperative mechanical ventilation initiation is required
`99100`	Anesthesia for patient of extreme age, under 1 year	Billed by anesthesiology when providing anesthesia for neonates/infants undergoing pulmonary artery banding

CPT 33600: Cardiac Valve Repair by Patch or Suture

CPT-33602-SEMILUNAR-VALVE-REPAIR-AORTIC-PULMONARY-REGURGITATION

CPT 33602: Repair of Aortic or Pulmonary Semilunar Valve Regurgitation

CPT-33606-DOUBLE-INLET-VENTRICLE-PULMONARY-ARTERY-TO-AORTA-JOIN

CPT 33606: Pulmonary Artery to Aorta Join for Double Inlet Ventricle

CPT-33608-VENTRICLE-TO-PULMONARY-ARTERY-CONDUIT-REPAIR

CPT 33608: Ventricle-to-Pulmonary Artery Conduit or Graft Repair

CPT-33610-VENTRICULAR-SEPTAL-DEFECT-ENLARGEMENT-VALVED-DEVICE

CPT 33610: Ventricular Septal Defect Enlargement with Valved Device

CPT-33611-VENTRICULAR-SEPTAL-DEFECT-TUNNEL-GRAFT-TO-AORTA

CPT 33611: Tunnel Graft from VSD to Aorta

CPT-33612-INTRAVENTRICULAR-TUNNEL-GRAFT-VSD-REPAIR

CPT 33612: Intraventricular Tunnel Graft for VSD with Outflow Tract Repair

CPT-33615-ATRIAL-SEPTAL-DEFECT-PATCH-AND-PULMONARY-ARTERY-ANASTOMOSIS

CPT 33615: Atrial Septal Defect Patch and Pulmonary Artery Anastomosis

CPT-33617-SUPERIOR-VENA-CAVA-TO-PULMONARY-ARTERY-CONNECTION

CPT 33617: Superior Vena Cava to Pulmonary Artery Connection

CPT-33619-NORWOOD-PROCEDURE-HLHS-AORTIC-ARCH-RECONSTRUCTION

CPT 33619: Norwood Procedure for HLHS and Aortic Arch Reconstruction

Showing 1–10 of 12

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
`00`	No modifier — standard reporting	Use when no additional modifier applies and service is billed routinely
`11`	Provider's usual and customary service	Use when the procedure is performed as the usual service by the billing provider
`22`	Increased procedural service	Use when the procedure required substantially greater work than typical (document justification)
`23`	Unusual anesthesia — medically necessary	Use when general anesthesia is contraindicated and unusual anesthesia circumstances occur (document)
`62`	Two surgeons	Use when two surgeons with distinct skills actively participate in the procedure
`63`	Procedure performed on infants less than 4 kg	Use when special infant weight-based reporting applies (document weight)
`73`	Discontinued outpatient procedure prior to anesthesia	Use when planned outpatient procedure is terminated before anesthesia is given
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned
`53`	Discontinued procedure	Use when the procedure is terminated after anesthesia induction for patient safety
`78`	Return to operating room for related procedure during postoperative period	Use when patient returns to OR for a related complication in the global period
`80`	Assistant surgeon	Use when an assistant surgeon is required and documented
`81`	Minimum assistant surgeon	Use when minimal assistance is provided and meets payer criteria
`26`	Professional component	Rare for a surgical procedure; use when only professional component is billed distinct from facility
`51`	Multiple procedures	Use when additional distinct procedures are performed during the same operative session (list separately)

Taxonomy Code	Specialty	Notes
208100000X	Cardiothoracic Surgery	Primary specialty performing pulmonary artery banding
207P00000X	Pediatric Cardiac Surgery	Subspecialty for neonates and infants with congenital heart disease
207L00000X	Pediatric Surgery	Often involved in congenital thoracic procedures for infants
207Q00000X	Thoracic Surgery	May perform when approach is thoracotomy in older children
2080S0122X	Cardiac Surgery Critical Care	Involved in perioperative management and ICU care

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q21.0`	Ventricular septal defect	Large VSDs cause left-to-right shunt leading to pulmonary overcirculation managed initially by banding
`Q25.0`	Patent ductus arteriosus	Significant PDA with excessive pulmonary blood flow may be temporized with pulmonary artery banding in select infants
`Q21.2`	Atrioventricular septal defect	AV septal defects can produce high pulmonary flow and benefit from staged banding prior to complete repair
`Q21.1`	Atrial septal defect	Large defects with symptomatic overload in infancy may be part of complex physiology leading to banding decisions
`I50.1`	Left ventricular failure	Congestive heart failure resulting from volume overload is an indication to reduce pulmonary flow with banding
`I27.0`	Primary pulmonary hypertension	Banding may be performed to prevent progression of pulmonary vascular disease in certain congenital shunts
`P28.5`	Pulmonary hemorrhage originating in the perinatal period	Severe pulmonary overcirculation and respiratory compromise in neonates may prompt temporizing banding
`Z95.2`	Presence of prosthetic heart valve	Relevant in postoperative staged care or complex reoperations where pulmonary flow control may be required

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93451`	Right and left heart catheterization including intraprocedural congenital heart disease interventions	Used preoperatively to assess hemodynamics and pulmonary vascular resistance before banding
`93306`	Echocardiography, transthoracic, complete, real-time imaging	Used for diagnostic assessment and postoperative monitoring of band effect
`33405`	Repair of ventricular septal defect (VSD), closure; primary	Represents a staged definitive repair often performed after initial pulmonary artery banding in infants
`99291`	Critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 minutes	Used for postoperative ICU management of infants after banding when critical care time is documented
`94002`	Ventilation assist and management, initiation of pressure or volume preset ventilator for acute respiratory failure; hospital inpatient/observation	May be reported when postoperative mechanical ventilation initiation is required
`99100`	Anesthesia for patient of extreme age, under 1 year	Billed by anesthesiology when providing anesthesia for neonates/infants undergoing pulmonary artery banding

CPT 33600: Cardiac Valve Repair by Patch or Suture

CPT-33602-SEMILUNAR-VALVE-REPAIR-AORTIC-PULMONARY-REGURGITATION

CPT 33602: Repair of Aortic or Pulmonary Semilunar Valve Regurgitation

CPT-33606-DOUBLE-INLET-VENTRICLE-PULMONARY-ARTERY-TO-AORTA-JOIN

CPT 33606: Pulmonary Artery to Aorta Join for Double Inlet Ventricle

CPT-33608-VENTRICLE-TO-PULMONARY-ARTERY-CONDUIT-REPAIR

CPT 33608: Ventricle-to-Pulmonary Artery Conduit or Graft Repair

CPT-33610-VENTRICULAR-SEPTAL-DEFECT-ENLARGEMENT-VALVED-DEVICE

CPT 33610: Ventricular Septal Defect Enlargement with Valved Device

CPT-33611-VENTRICULAR-SEPTAL-DEFECT-TUNNEL-GRAFT-TO-AORTA

CPT 33611: Tunnel Graft from VSD to Aorta

CPT-33612-INTRAVENTRICULAR-TUNNEL-GRAFT-VSD-REPAIR

CPT 33612: Intraventricular Tunnel Graft for VSD with Outflow Tract Repair

CPT-33615-ATRIAL-SEPTAL-DEFECT-PATCH-AND-PULMONARY-ARTERY-ANASTOMOSIS

CPT 33615: Atrial Septal Defect Patch and Pulmonary Artery Anastomosis

CPT-33617-SUPERIOR-VENA-CAVA-TO-PULMONARY-ARTERY-CONNECTION

CPT 33617: Superior Vena Cava to Pulmonary Artery Connection

CPT-33619-NORWOOD-PROCEDURE-HLHS-AORTIC-ARCH-RECONSTRUCTION

CPT 33619: Norwood Procedure for HLHS and Aortic Arch Reconstruction

Showing 1–10 of 12

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.

Published by

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 33620: Bilateral Pulmonary Artery Banding to Reduce Left-to-Right Shunt

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Billing Code Overview

OpenPayer

CPT 33620: Bilateral Pulmonary Artery Banding to Reduce Left-to-Right Shunt

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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