Summary & Overview
CPT 33688: Ventricular Septal Defect Repair with Pulmonary Artery Band Removal
CPT code 33688 represents open surgical repair of a ventricular septal defect (VSD), often performed when a hole in the wall between the heart’s ventricles must be closed to prevent mixing of oxygenated and deoxygenated blood. The code covers closure with patch or sutures and may include removal of a prior pulmonary artery band and reinforcement of the pulmonary artery with a gusset. This procedure is clinically significant because timely and effective VSD repair prevents long-term cardiac dysfunction, pulmonary overcirculation, and hypoxia, affecting surgical practice patterns and hospital resource utilization nationwide.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service, expected site of care, and the typical surgical components captured by the code. The publication provides benchmarking context, common modifier usage, and coding considerations relevant to cardiothoracic surgical case mix and hospital billing workflows. It also highlights clinical context for when pulmonary artery band removal and gusset reinforcement are performed alongside VSD closure, enabling billing and policy professionals to align coding with operative reports and institutional billing policies.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 33688 describes a surgical procedure to close a ventricular septal defect (VSD). The provider closes a hole in the septum between the heart's ventricles using a patch or sutures to prevent mixing of oxygenated and deoxygenated blood. The procedure may include removal of a prior pulmonary artery band placed as a temporary treatment for a VSD and the addition of a gusset to reinforce a patch on the pulmonary artery.
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Service type: Surgical repair of ventricular septal defect (open cardiac surgery)
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Typical site of service: Inpatient hospital setting, operating room with cardiothoracic surgery capabilities
Clinical & Coding Specifications
Clinical Context
A 6-month-old infant with a significant perimembranous ventricular septal defect (VSD) and prior palliation with a pulmonary artery (PA) banding presents for definitive surgical repair. Preoperative evaluation includes echocardiography demonstrating left-to-right shunt with chamber enlargement and evidence of PA band causing proximal pulmonary artery narrowing. The cardiac surgery team performs a median sternotomy, removes the PA band, exposes the VSD, and closes the defect with a patch or primary sutures; a gusset may be added to reinforce repair at the pulmonary artery when indicated. Typical perioperative workflow includes preoperative anesthesia evaluation, cardiopulmonary bypass with aortic cross-clamping, intraoperative transesophageal echocardiography to confirm patch position and residual shunt assessment, and postoperative ICU monitoring for hemodynamics and ventilation support.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Use when no other modifier applies and standard reporting is required |
11 | Office/outpatient evaluation and management (as informational) | Rarely appended; used by some payors to indicate standard service without unusual circumstances |