Summary & Overview
CPT 33755: Aorto-Pulmonary Shunt (Waterston-Type) Surgery
CPT code 33755 represents a surgical aorto-pulmonary shunt (Waterston-type) created between the ascending aorta and the pulmonary artery to increase pulmonary blood flow and improve oxygenation in patients with cyanotic congenital heart defects. This procedure is an important component of congenital cardiac surgery and remains relevant nationally for tertiary pediatric cardiac centers and hospitals that provide complex cardiac surgical care. Payers commonly covering this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
This publication provides a concise national overview of CPT code 33755, including clinical context, expected site of service, and the types of benchmarks and policy considerations readers can expect. Readers will learn: procedural intent and typical care setting, common modifiers associated with surgical services (listed separately), payer coverage patterns and how major national payers approach authorization and coding for congenital cardiac shunts, and where to find related coding references. Data not available in the input is noted where applicable. The summary serves clinicians, coding professionals, and policy analysts seeking a focused reference on this specific congenital cardiac surgical code.
Billing Code Overview
CPT code 33755 describes a surgical procedure that creates a shunt between the ascending aorta and the pulmonary artery (also known as a Waterston-type operation). The shunt forms a bypass channel that diverts blood to increase pulmonary blood flow and improve systemic oxygenation in patients with cyanosis from congenital heart defects and inadequate native pulmonary blood flow.
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Service type: Surgical cardiac shunt creation, congenital heart surgery
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Typical site of service: Inpatient hospital, operating room or cardiac surgery suite
Clinical & Coding Specifications
Clinical Context
A typical patient is an infant or young child with cyanotic congenital heart disease and inadequate pulmonary blood flow, such as tetralogy of Fallot with severe pulmonary stenosis or pulmonary atresia. The patient presents with persistent central cyanosis, poor weight gain, and episodic hypoxemia despite medical management. Preoperative evaluation includes echocardiography to define intracardiac anatomy, chest radiography, arterial blood gas, and cardiac catheterization when needed. The procedure, a systemic-to-pulmonary arterial shunt (Waterston-type), is performed in the operating room under general anesthesia with cardiothoracic surgical team, pediatric cardiac anesthesiology, perfusion support on standby if required, and postoperative admission to the pediatric cardiac intensive care unit. Intraoperative steps include median sternotomy or thoracotomy exposure, identification of the ascending aorta and right pulmonary artery, creation of an anastomosis or placement of a conduit to divert systemic blood to the pulmonary circulation, hemostasis, and chest tube placement. Postoperative care focuses on oxygenation, hemodynamic monitoring, anticoagulation as indicated, assessment of shunt patency via pulse oximetry and echocardiography, and planning for definitive intracardiac repair at a later date if appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | Use for routine, uncomplicated reporting when no special circumstances apply |