CPT 33720 Sinus of Valsalva Repair Reimbursement | OpenPayer

Summary & Overview

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

CPT code 33720 identifies open surgical repair of a sinus of Valsalva aneurysm or structural dilation in the ascending aorta performed with cardiopulmonary bypass. This code applies to complex cardiothoracic operative management of aortic root or proximal ascending aortic pathology and is relevant to hospitals, cardiothoracic surgery groups, and payers managing high-acuity vascular and cardiac cases nationwide. Key national payers in typical coverage analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn the clinical scope of the code, typical service setting and team composition, common billing modifiers and service line associations (where available), and how this procedure is categorized for payer coverage and claims processing. The publication summarizes benchmarks and policy considerations affecting authorization and coverage for complex aortic surgeries, outlines the procedure's place in surgical treatment algorithms, and highlights documentation elements that commonly influence medical necessity reviews. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare33720CPTcardiothoracic surgeryaortic repairsinus of Valsalvacardiopulmonary bypassinpatient surgery

Billing Code Overview

CPT code 33720 describes the surgical repair of a sinus of Valsalva aneurysm or structural dilation of the ascending aorta. The procedure involves open cardiac surgery with placement of the patient on cardiopulmonary bypass to allow direct repair of the aortic sinus or ascending aortic segment.

Service type: Open cardiothoracic surgical repair
Typical site of service: Inpatient hospital operating room, commonly performed by cardiothoracic surgeons with full cardiopulmonary bypass support

Clinical & Coding Specifications

Clinical Context

A 58-year-old male presents with progressive exertional dyspnea and a newly detected continuous murmur. Transthoracic and transesophageal echocardiography identify a ruptured or enlarging sinus of Valsalva aneurysm originating from the right coronary sinus with shunting into the right atrium and associated dilation of the ascending aorta. The patient is scheduled for surgical repair of the sinus of Valsalva aneurysm under general anesthesia with placement on cardiopulmonary bypass.

Preoperative workflow includes cross-sectional imaging (CT angiography) to define the aneurysm and aortic root anatomy, cardiology consultation, preop labs and blood typing, and informed consent for open repair. Intraoperative steps include median sternotomy, institution of cardiopulmonary bypass, aortic cross-clamp, direct inspection of the aortic root, excision or patch repair of the aneurysmal sinus, possible reinforcement or replacement of aortic tissue, and deairing before separation from bypass. Postoperative care includes intensive care monitoring, hemodynamic support, surveillance for bleeding or conduction abnormalities, and follow-up imaging and cardiology evaluation prior to discharge.

Coding Specifications

Modifier	Description	When to Use
`00`	Reason not given (not standard; placeholder in input)	Data not available in the input.

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

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

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

Taxonomy Code	Specialty	Notes
Data not available in the input.	Cardiothoracic Surgery	Cardiothoracic surgeons most commonly perform open sinus of Valsalva repairs.
Data not available in the input.	Cardiovascular Surgery	Cardiovascular surgical specialists perform complex aortic root and ascending aorta repairs.
Data not available in the input.	Cardiac Surgery	Cardiac surgeons experienced with aortic pathology manage these cases.
Data not available in the input.	Vascular Surgery	Vascular surgeons may be involved when ascending aortic reconstruction is required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I71.1`	Thoracic aortic aneurysm, ruptured	Represents thoracic aortic aneurysm involving the ascending aorta that may necessitate urgent repair.
`I71.2`	Thoracic aortic aneurysm, without rupture	Describes ascending aortic aneurysm or dilatation that can be associated with sinus of Valsalva aneurysm.
`I97.120`	Postprocedural rupture of thoracic aorta	Relevant if repair is being done for a postprocedural complication.
`I35.0`	Nonrheumatic aortic (valve) stenosis	May coexist requiring valve repair or replacement during operative management.
`I35.1`	Nonrheumatic aortic (valve) insufficiency	Aortic regurgitation often accompanies sinus of Valsalva pathology and influences surgical planning.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`00561`	Anesthesia for procedures on heart and pericardial sac; cardiopulmonary bypass	Anesthesia code commonly reported for cases requiring cardiopulmonary bypass during open aortic root repair.
`33361`	Repair of ventricular septal defect with patch (open, with cardiopulmonary bypass)	May be performed concurrently if sinus of Valsalva aneurysm has ruptured into a cardiac chamber creating a VSD-like defect.
`33405`	Replacement, aortic valve, with cardiopulmonary bypass	Performed when aortic valve disease is present and valve replacement is required during the same operative session.
`33533`	Coronary artery bypass, single vessel, with cardiopulmonary bypass (CABG)	Frequently performed concomitantly if coronary artery disease requires bypass during open heart surgery.
`33600`	Repair of ascending aorta, with cardiopulmonary bypass	Used when additional ascending aortic repair or grafting is required beyond the sinus of Valsalva repair.

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