Summary & Overview
CPT 33768: Left SVC to Left Pulmonary Artery Shunt Creation
CPT code 33768 represents a specific cardiac surgical procedure performed during corrective surgery for congenital or acquired cardiac anomalies: surgical creation of a shunt between the left superior vena cava and the left pulmonary artery to divert deoxygenated blood to the lungs and reduce cardiac workload. Nationally, this code is relevant to tertiary cardiac centers and pediatric and adult congenital heart programs where complex intracardiac and extracardiac reconstructions are performed.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, typical sites of service, and the operational implications for surgical programs. The publication provides benchmarks where available, notes on billing and claim considerations, and summaries of policy factors that commonly affect coverage and coding for complex cardiac surgical services.
This summary serves clinicians, coding professionals, and policy analysts seeking a concise national-level briefing on the procedure represented by CPT code 33768, how it is reported, and the contexts in which it is typically performed. Data not available in the input are explicitly omitted from this overview.
Billing Code Overview
CPT code 33768 describes a surgical procedure in which a shunt is created between the left superior vena cava and the left pulmonary artery during a separate cardiac anomaly correction. The intent of the procedure is to divert deoxygenated blood to the lungs and reduce cardiac workload.
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Service type: Cardiac surgical shunt creation performed as part of corrective cardiac surgery
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Typical site of service: Inpatient operating room or cardiac surgical suite
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or young adult with complex congenital heart disease (for example, congenitally corrected transposition, single ventricle physiology with persistent left superior vena cava, or other cardiac venous anomalies) who is undergoing a planned corrective cardiac operation. During the primary cardiac anomaly correction procedure, the surgeon identifies a left superior vena cava (LSVC) draining systemic venous blood in a way that continues to increase right atrial/ventricular volume load or causes inadequate pulmonary blood flow. The provider surgically creates a shunt between the left superior vena cava and the left pulmonary artery to divert deoxygenated blood directly to the pulmonary circulation, reduce mixing, and decrease cardiac workload.
The clinical workflow includes preoperative imaging (echocardiography, cardiac MRI/CT, and catheterization as needed), multidisciplinary planning with cardiology and cardiothoracic surgery, intraoperative monitoring and cardiopulmonary bypass if required, creation of the LSVC-to-left pulmonary artery shunt in the same operative session as the primary cardiac repair, and postoperative ICU care with hemodynamic monitoring and follow-up imaging to confirm shunt patency and effective pulmonary perfusion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |