Summary & Overview
CPT 33782: Aortic Root to Pulmonary Position with VSD and RVOT Reconstruction
CPT code 33782 designates a specialized cardiothoracic operation for congenital heart disease involving relocation of the aortic root to the pulmonary position, excision of the pulmonary valve, reconstruction of ventricular outflow tracts, repair of a ventricular septal defect, and correction of pulmonary artery stenosis without coronary ostium reimplantation. This procedure is clinically significant due to its role in managing complex congenital cardiac anatomy and its implications for surgical risk, resource use, and postoperative care.
Key payers included in the national analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, common billing modifiers, and areas where coding clarity matters for authorization and reimbursement. The publication outlines national benchmarks and policy-relevant issues affecting coverage and billing for high-acuity congenital cardiac procedures, highlights clinical considerations that influence coding choices, and identifies gaps where input or updated guidance may be needed.
Data not available in the input is noted where specific payer policies, associated taxonomies, exact ICD-10 diagnoses, related codes, and service-line cost benchmarks would normally be summarized.
Billing Code Overview
CPT code 33782 describes a complex congenital heart surgery in which the provider relocates the aortic root to the pulmonary position, excises the pulmonary valve, and reconstructs the ventricular outflow tracts. The procedure includes repair of a ventricular septal defect and correction of pulmonary artery stenosis, but does not include coronary ostium reimplantation.
Service type: Cardiac surgical procedure — congenital heart repair
Typical site of service: Inpatient hospital, operating room (cardiothoracic surgery)
Clinical & Coding Specifications
Clinical Context
A typical patient is an infant or child with complex congenital heart disease presenting with truncus arteriosus or double outlet right ventricle with a large ventricular septal defect and malpositioned great arteries causing obstruction of the right ventricular outflow tract and pulmonary stenosis. The patient is evaluated by pediatric cardiology and cardiothoracic surgery after diagnostic workup that includes transthoracic echocardiography, cardiac MRI or CT angiography, and cardiac catheterization to define coronary anatomy and pulmonary artery branches. Preoperative optimization includes management of heart failure symptoms, oxygenation, and possible prostaglandin therapy in neonates.
Surgically, the patient undergoes corrective open-heart surgery with cardiopulmonary bypass under general anesthesia. The operative steps for 33782 include mobilization and translocation of the aortic root into the pulmonary position, excision of the native pulmonary valve, reconstruction of the ventricular outflow tracts, closure of the ventricular septal defect, and repair or patch augmentation of pulmonary artery stenosis. Coronary ostia are not reimplanted in this specific procedure. Postoperative care occurs in a pediatric cardiac intensive care unit with hemodynamic monitoring, ventilatory support as needed, inotropic support, and serial imaging to assess repair integrity. Follow-up includes serial echocardiography and long-term surveillance for residual obstruction, valve dysfunction, or arrhythmia.
Coding Specifications
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