Summary & Overview
CPT 33766: Superior Vena Cava to Right Pulmonary Artery Shunt (Classical Glenn)
CPT code 33766 represents the classical Glenn procedure, a cardiothoracic surgical operation that creates a shunt between the superior vena cava and the right pulmonary artery to redirect systemic venous blood into the pulmonary circulation for oxygenation. This palliative congenital heart surgery is performed primarily in an inpatient operating room and is clinically significant for patients with single-ventricle physiology or other right-sided cardiac defects. Nationally, the procedure is important for pediatric and congenital heart programs and affects reimbursement and care pathway planning across major payers.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent and setting for the procedure, typical payer coverage considerations, and the scope of benchmarking and policy topics that usually accompany complex congenital cardiac surgeries. The publication covers coding context, common modifiers reported with complex surgical services, typical sites of service and service line classification, and implications for inpatient billing workflows. Data not available in the input is clearly indicated where applicable. The content is intended to inform clinicians, hospital billing teams, and policy stakeholders about the clinical and administrative profile of CPT code 33766 without offering clinical recommendations.
Billing Code Overview
CPT code 33766 describes a surgical creation of a shunt between the superior vena cava and the right pulmonary artery, commonly known as the classical Glenn procedure. The operation establishes a bypass channel so venous blood is diverted from a defective right heart chamber directly into the pulmonary artery for oxygenation in one lung.
-
Service type: Surgical cardiovascular procedure (palliative/congenital heart surgery)
-
Typical site of service: Inpatient hospital operating room with cardiothoracic surgical services
Clinical & Coding Specifications
Clinical Context
A pediatric patient, typically an infant or young child with cyanotic congenital heart disease such as single ventricle physiology (e.g., tricuspid atresia or hypoplastic right ventricle), presents for staged palliation. The patient has persistent hypoxemia and a prior neonatal procedure (such as a modified Blalock-Taussig shunt) or is progressing toward a bidirectional Glenn/staged superior cavopulmonary connection. The surgical team evaluates the child in preoperative clinic with focused cardiology assessment, transthoracic echocardiography, and cross-sectional imaging as needed. Preoperative optimization includes assessment of pulmonary artery anatomy and pressures, hematocrit management, and anesthesia planning. In the operating room, under general anesthesia and with cardiothoracic surgical technique, the surgeon creates a direct anastomosis (shunt) between the superior vena cava and the right pulmonary artery — the classical Glenn procedure — to divert systemic venous return from the upper body directly into the pulmonary circulation for oxygenation. Typical workflow includes preoperative consent, intraoperative transesophageal or epicardial echo as indicated, intensive care unit postoperative monitoring, chest tube management, and staged planning for future Fontan completion if clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard/Neutral (no modifier) | Use when no specific modifier applies and the procedure is reported without alteration. |