Summary & Overview
CPT 33647: Atrial and Ventricular Septal Defect Repair
CPT code 33647 denotes surgical closure of defects in the atrial and ventricular septa using sutures or patch material to prevent intracardiac mixing of oxygenated and deoxygenated blood. This open cardiac procedure is a key intervention for significant congenital or acquired septal defects and carries important implications for perioperative resource use, inpatient care pathways, and clinical outcomes across the U.S. healthcare system. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical context for the procedure, typical sites of service, and the service line classification. The publication provides payer-aligned benchmarks and coverage considerations, highlights common billing modifiers, and situates 33647 within related cardiac surgical services to aid coding and claims adjudication. It also outlines how this code relates to resource utilization in inpatient cardiac surgery settings and what aspects of documentation and coding commonly affect reimbursement and compliance reviews. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 33647 describes surgical repair of defects in the atrial and ventricular septa using sutures or a patch (such as Dacron® or pericardium) to prevent mixing of oxygenated and deoxygenated blood between heart chambers. This procedure addresses congenital or acquired septal defects by closing holes in the walls between the heart's chambers.
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Service type: Open cardiac surgical repair of atrial and ventricular septal defects
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Typical site of service: Inpatient hospital operating room, often performed by cardiothoracic surgeons under general anesthesia
Clinical & Coding Specifications
Clinical Context
A pediatric or adult patient with an atrial and/or ventricular septal defect presents for surgical repair to prevent paradoxical embolism, heart failure, and chronic hypoxemia. Typical presentation includes exertional dyspnea, fatigue, recurrent respiratory infections in children, or new onset heart murmur detected on exam with echocardiographic confirmation of a defect. Preoperative evaluation includes transthoracic or transesophageal echocardiography, cardiac catheterization if pulmonary vascular resistance assessment is needed, routine labs, anesthesiology assessment, and informed consent.
The patient is admitted to the cardiovascular surgical service for open surgical repair under general endotracheal anesthesia. The operative workflow includes median sternotomy, cardiopulmonary bypass, cardioplegic arrest, exposure of the atrial and/or ventricular septum, direct suture closure or patch closure using autologous pericardium or synthetic material such as Dacron®, intraoperative transesophageal echocardiography to confirm closure and rule out residual shunt, weaning from bypass, hemostasis, chest closure, and postoperative transfer to the cardiac intensive care unit for monitoring, ventilatory support as needed, and routine postoperative care including pain control and imaging follow-up before discharge.
Typical site of service is an inpatient hospital operating room with subsequent recovery and intensive care stay. The service type is open cardiac surgical repair of septal defects.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
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