Summary & Overview
CPT 33660: Cardiac Septal Closure with Valve Repair
CPT code 33660 represents open cardiac surgical repair to close a defect in the wall between the atria and ventricles, often using sutures or a patch of Dacron® or pericardium, with concurrent repair of the tricuspid and mitral valves as indicated. This procedure is critical in treating structural heart defects that disrupt intracardiac blood flow and valve function, with significant implications for surgical outcomes and postoperative care across hospital systems nationwide.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national perspective on clinical context and billing considerations relevant to facilities and clinicians performing complex intracardiac repairs.
Readers will find a concise clinical description of the procedure, typical site-of-service expectations, and an overview of common modifiers and payer coverage patterns where available. The report outlines benchmarks for coding practice, potential policy updates affecting coverage, and the clinical circumstances under which valve repair is performed alongside septal closure. Data not available in the input is noted where applicable, and the piece focuses on giving clinicians, billing professionals, and policy analysts a clear, operational summary of CPT code 33660.
Billing Code Overview
CPT code 33660 describes a surgical procedure to close a defect in the wall between the heart's atria and ventricles by suturing the area or using a patch made of Dacron® material or pericardium. The procedure includes assessment and repair of the tricuspid and mitral valves as needed to ensure proper leaflet placement based on the severity of any valve defect.
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Service type: Cardiac surgical repair involving intracardiac septal and valvular reconstruction
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Typical site of service: Hospital inpatient or operating room for open cardiac surgery
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient with a history of progressive dyspnea on exertion, peripheral edema, and a holosystolic murmur is evaluated by cardiology and found on transthoracic and transesophageal echocardiography to have a large ventricular septal defect (VSD) with left-to-right shunt and associated tricuspid valve malcoaptation. Coronary angiography demonstrates no prohibitive coronary disease. The patient is scheduled for open surgical repair of the VSD with patch closure using Dacron® or pericardial patch and concurrent tricuspid valve repair under general anesthesia with cardiopulmonary bypass.
The clinical workflow includes preoperative evaluation (cardiac imaging, labs, anesthesia assessment), operative repair in the cardiac operating room with median sternotomy, cardiopulmonary bypass, exposure of the defect, patch closure (CPT 33660) and valve repair as indicated, intraoperative transesophageal echocardiography confirmation of repair, intensive care monitoring postoperatively, and staged inpatient recovery with cardiac rehabilitation planning. Typical site of service is an inpatient acute care hospital; the service type is inpatient cardiac surgical procedure performed by cardiothoracic surgery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Exempt from certification or documentation requirements | Use when payer-specific certification/exemption applies per contract (rare). |