CPT 33710 Repair Sinus of Valsalva — Reimbursement | OpenPayer

Summary & Overview

CPT 33710: Repair of Sinus of Valsalva Fistula with Ventricular Septal Defect Repair

CPT code 33710 represents an open cardiothoracic surgical procedure to repair a sinus of Valsalva fistula or dilation of the ascending aorta communicating with the heart, performed with cardiopulmonary bypass and including repair of an associated ventricular septal defect. This is a high-acuity cardiac surgery code with implications for hospital resource use, operative team staffing, and post-operative inpatient care nationally. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context of the procedure, typical site-of-service and service type, and which major payers are relevant for coverage and payment discussions. The publication also provides benchmarking and policy context where available, outlines common billing considerations and modifiers, and summarizes areas where additional coding detail or clinical documentation commonly affects reimbursement. Data gaps are noted where input information was not provided. This overview is intended for coders, billing managers, hospital administrators, and policy analysts who need a clear, national-level briefing on the role and implications of CPT code 33710 in care delivery and payment workflows.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare33710CPTcardiac-surgerysinus-of-valsalvaventricular-septal-defectcardiopulmonary-bypassinpatient-surgery

Billing Code Overview

CPT code 33710 describes a surgical procedure to repair a sinus of Valsalva fistula or structural dilation of the ascending aorta that communicates with the heart, with concurrent repair of a ventricular septal defect (VSD). The procedure is performed with the patient placed on cardiopulmonary bypass.

Service type: Open cardiac surgical repair involving intracardiac and aortic root reconstruction.
Typical site of service: Inpatient hospital, operating room with cardiothoracic surgical team and cardiopulmonary bypass capability.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 52-year-old male presents with progressive exertional dyspnea, palpitations, and an episode of syncope. Transthoracic echocardiography and CT angiography identify a ruptured sinus of Valsalva fistula from the right coronary sinus into the right ventricle and a concomitant perimembranous ventricular septal defect (VSD) with left-to-right shunt and mild aortic root dilation. Cardiac catheterization confirms left-to-right shunting and normal coronary anatomy. The patient is scheduled for open surgical repair under general anesthesia with placement on cardiopulmonary bypass. Intraoperative steps include median sternotomy, aortic cross-clamp, cardioplegia, excision and patch repair of the sinus of Valsalva fistula, closure of the VSD with a synthetic or pericardial patch, inspection and repair of aortic valve/root if needed, and weaning from bypass. Typical perioperative workflow involves preoperative imaging and testing, multidisciplinary surgical and anesthesia planning, intraoperative transesophageal echocardiography to confirm repair integrity, postoperative ICU monitoring for hemodynamics and potential arrhythmias, and follow-up echocardiography prior to discharge. Typical site of service is an inpatient tertiary care center with cardiothoracic surgery capability, cardiac operating room, and an intensive care unit.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Use when no other specific modifier is applicable and professional rules require it.

CPT 33720: Repair of Sinus of Valsalva Aneurysm or Ascending Aorta

CPT-33702-CLOSURE-SINUS-OF-VALSALVA-CORONARY-ARTERY-FISTULA

CPT 33702: Closure of Sinus of Valsalva–Coronary Artery Fistula

Taxonomy Code	Specialty	Notes
207L00000X	Thoracic Surgery	Primary specialty performing complex aortic root and VSD repairs.
2080P0200X	Cardiovascular Surgery	Cardiac surgeons who perform open heart procedures with cardiopulmonary bypass.
207RC0000X	Surgery - Cardiovascular & Thoracic	Broad specialty covering combined expertise for these repairs.
2086S0105X	Cardiac Surgery	Focused cardiac surgery taxonomy for operative management of structural heart defects.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I35.0`	Nonrheumatic aortic (valve) stenosis	Aortic valve disease can coexist with sinus/root pathology and may require repair or replacement during surgery.
`I35.1`	Nonrheumatic aortic (valve) insufficiency	Aortic regurgitation often accompanies sinus of Valsalva defects and influences surgical planning.
`Q21.0`	Ventricular septal defect	Direct indication for VSD closure; commonly repaired during the same operation.
`I71.2`	Thoracic aortic aneurysm, without rupture	Ascending aortic dilation may be present and necessitate concurrent aortic repair.
`I97.810`	Intraoperative cardiac complications, not elsewhere classified	Coded if intraoperative complications occur and require separate reporting.
`I33.0`	Acute and subacute infective endocarditis	Infection can cause sinus or VSD defects; operative repair may be needed after infection control.
`I42.0`	Dilated cardiomyopathy	Preoperative ventricular dysfunction relevant for risk stratification and perioperative management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33533`	Repair of ruptured sinus of Valsalva with primary or patch closure without cardiopulmonary bypass	Alternative surgical technique; may be listed if performed without bypass but typically less extensive than `33710`.
`33405`	Replacement, aortic valve, with cardiopulmonary bypass	Performed if significant aortic valve pathology is encountered and valve replacement is required during the same operation.
`33426`	Repair of ascending aorta with cardiopulmonary bypass (tube graft)	Performed when associated ascending aortic aneurysm or root dilation requires graft replacement in conjunction with sinus repair.
`33430`	Aortic root replacement (e.g., Bentall procedure) with cardiopulmonary bypass	Performed when combined aortic root and valve replacement are necessary rather than isolated sinus repair.
`93503`	Insertion and positioning of intracardiac catheter (e.g., pulmonary artery)	Cardiac catheterization procedures performed preoperatively or intraoperatively for hemodynamic monitoring or diagnostic confirmation.

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