Summary & Overview
CPT 33736: Atrial Septal Resection or Creation, Open Heart
CPT code 33736 denotes an open cardiac surgical procedure to remove or create an opening in the atrial septum while the patient is supported on cardiopulmonary bypass. This operation is a specialized intracardiac intervention typically performed for congenital or acquired atrial septal pathologies and matters nationally because it involves high-acuity inpatient care, significant resource use, and coordination across surgical, perfusion, and intensive care teams.
Key payers considered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, discussion of common sites of service and service type, and an overview of benchmarking and policy-relevant considerations where available. The publication highlights typical utilization settings, care intensity implications, and payer coverage patterns relevant to hospitals, cardiovascular surgical programs, and revenue cycle teams.
What readers will learn: a clear definition of the service represented by CPT code 33736, expected clinical and operational settings for the procedure, which major national payers are included in comparative coverage discussions, and where input data is missing. Data gaps are identified so payers and providers can seek detailed local and contractual information for reimbursement and coding practices.
Billing Code Overview
CPT code 33736 describes an open surgical procedure in which the provider removes the atrial septum or intentionally creates an opening in the atrial septum, the tissue wall separating the right and left atria of the heart. This procedure is performed on cardiopulmonary bypass and therefore is classified as open heart surgery.
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Service type: Surgical cardiac procedure; intracardiac septal modification performed with cardiopulmonary bypass
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Typical site of service: Inpatient hospital operating room or cardiac surgery suite during an open heart operation
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 6–12 month old infant or a young child with cyanotic congenital heart disease such as hypoplastic left heart syndrome, transposition of the great arteries with intact ventricular septum, or other defects causing inadequate interatrial communication. The patient presents with progressive hypoxemia, failure to thrive, or marked atrial level restriction on echocardiography despite medical management. The cardiothoracic surgery team evaluates the child in the inpatient setting with preoperative transthoracic and transesophageal echocardiography, cardiac catheterization as indicated, and multidisciplinary planning with pediatric cardiology, anesthesia, perfusion, and intensive care.
The procedure, an open atrial septectomy or creation of an interatrial communication performed on cardiopulmonary bypass, is scheduled in the operating room under general anesthesia with cardiopulmonary bypass support. The surgical team performs median sternotomy, places cannulas for bypass, arrests or vents the heart as appropriate, and excises or creates a fenestration in the atrial septum to permit shunting between right and left atria. The patient is weaned from bypass, hemostasis confirmed, and transferred to the pediatric cardiac intensive care unit for postoperative monitoring, ventilatory support as needed, inotropic support, and serial echocardiography to confirm adequate interatrial communication and hemodynamic improvement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (unmodified procedure) |