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CPT 33800: Aortopexy for Tracheal Stabilization

CPT code 33800 represents aortopexy, a thoracic surgical procedure that affixes the aortic arch to the sternum to relieve severe tracheomalacia or external tracheal compression. This procedure addresses dynamic airway collapse and can be critical for patients with symptomatic airway obstruction that does not respond to conservative measures. Nationally, aortopexy is an important but infrequent intervention often performed in specialized surgical centers.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines clinical context for use of CPT code 33800, typical sites of service, and payer coverage patterns where available.

Readers will find a concise breakdown of the clinical indication and procedure type, an overview of common payer approaches to coverage, and benchmark information where available. The content highlights operational considerations for hospital-based surgical services and the role of aortopexy in managing severe tracheomalacia or tracheal compression. Data not available in the input is explicitly noted where applicable.

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Billing Code Overview

CPT code 33800 describes aortopexy, a surgical procedure in which the provider affixes the aortic arch to the sternum (breastbone) to relieve severe tracheomalacia or tracheal compression. The intent of the procedure is to open the trachea by repositioning and stabilizing the aortic arch relative to the airway.

Service type: Surgical airway stabilization procedure involving thoracic surgical techniques
Typical site of service: Hospital operating room or specialized surgical suite for thoracic/cardiac procedures

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CPT 33800: Aortopexy for Tracheal Stabilization

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Billing Code Overview

Service type: Surgical airway stabilization procedure involving thoracic surgical techniques
Typical site of service: Hospital operating room or specialized surgical suite for thoracic/cardiac procedures

Clinical & Coding Specifications

Clinical Context

A typical patient is an infant or young child with severe tracheomalacia or extrinsic tracheal compression from aortic arch anomaly (for example, a vascular ring or an aberrant innominate artery) who presents with recurrent stridor, respiratory distress, feeding difficulties, or recurrent lower respiratory tract infections. The clinical workflow begins with evaluation by a pediatric otolaryngologist and pediatric cardiothoracic surgeon. Diagnostic workup commonly includes flexible bronchoscopy to assess tracheal collapse, chest computed tomography (CT) or magnetic resonance imaging (MRI) to define vascular anatomy and compression, and pulmonary function assessment when feasible. After multidisciplinary discussion and surgical planning, the patient undergoes general endotracheal anesthesia and median sternotomy or upper sternotomy exposure. The provider performs an aortopexy by affixing the anterior surface of the aortic arch to the posterior aspect of the sternum to relieve anterior tracheal compression and stabilize the airway. Postoperative care includes intensive monitoring in a pediatric intensive care unit with attention to airway patency, ventilatory support as needed, pain control, and follow-up bronchoscopy or imaging to confirm airway improvement. Discharge planning involves coordination with pulmonology, otolaryngology, and cardiology for ongoing surveillance and management of comorbid conditions.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work required is substantially greater than typical for `33800` (document reasons and extent).
`23`	Unusual anesthesia	When medically necessary anesthesia services are provided under unusual circumstances unrelated to the procedure complexity.
`26`	Professional component	When reporting only the professional component of a related diagnostic service (e.g., professional reading of imaging) associated with perioperative care.
`50`	Bilateral procedure	Rarely applicable; use only if bilateral separate surgical fixes are performed and payer allows bilateral reporting.
`51`	Multiple procedures	When `33800` is billed on the same day with additional distinct surgical procedures; list and sequence correctly.
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the procedure is started but discontinued due to extenuating circumstances (use with documentation).
`62`	Two surgeons	When two surgeons from different specialties perform distinct portions of the operation concurrently.
`63`	Procedure performed on infants less than 4 kg	Use when payer requires weight-based modifier for neonatal/small infant surgery.
`78`	Unplanned return to the operating room	For a related return to OR for complications during the global period.
`79`	Unrelated procedure or service during global period	(Not in provided list) Data not available in the input.
`80`	Assistant surgeon	When a qualified assistant surgeon is required and documented.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	When appropriate and payer-specific rules allow billing under the supervising surgeon.

Taxonomy Code	Specialty	Notes
207P00000X	Pediatric Cardiothoracic Surgery	Primary specialty performing aortopexy in congenital or acquired vascular compression.
2080P0005X	Pediatric Otolaryngology	Airway assessment and surgical airway management; often co-manages perioperative bronchoscopy.
2080S0010X	Pediatric Surgery	Surgical management for infants and children when pediatric cardiothoracic coverage is not available.
207L00000X	Thoracic Surgery	Adult thoracic surgeons may perform aortopexy in older children or adults with tracheal compression.
2084P0813X	Pediatric Pulmonology	Not a surgical taxonomy but frequently involved in pre- and postoperative airway evaluation and follow-up.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31575`	Bronchoscopy, rigid or flexible, with or without tracheoscopy; diagnostic	Preoperative and postoperative airway assessment to document tracheomalacia and to evaluate results of `33800`.
`32440`	Repair, tracheoplasty, with or without cartilage graft; initial	Alternative or adjunct airway surgical procedure for structural tracheal reconstruction when aortopexy alone is insufficient.
`33010`	Median sternotomy, with or without sternal closure	Surgical approach commonly used to gain access to the aortic arch during `33800` (reported if listed separately per payer rules).
`33361`	Repair of vascular ring (thoracotomy or sternotomy)	Performed when aortic arch anomaly requires concomitant vascular repair in the same surgical episode.
`51702`	Bladder catheterization, simple (for drainage)	Perioperative urinary catheter placement code often billed in the operative period for fluid management and accurate output monitoring.

Related Codes

CPT-33802-ABERRANT-VESSEL-REPAIR

CPT 33802: Surgical Repair of Aberrant Vessel

CPT-33803-REPAIR-ABERRANT-ARTERY-REANASTOMOSIS

CPT 33803: Repair of Aberrant Artery with Reanastomosis

CPT-33814-AORTOPULMONARY-DEFECT-REPAIR-CARDIOPULMONARY-BYPASS

CPT 33814: Aortopulmonary Defect Repair with Cardiopulmonary Bypass

CPT-33820-DUCTUS-OR-MAJOR-VESSEL-LIGATION-AND-CLOSURE

CPT 33820: Ligation and Closure of Ductus or Major Cardiac Vessel

CPT-33822-PEDIATRIC-DUCTUS-DIVISION-AND-VESSEL-REPAIR

CPT 33822: Pediatric Ductus Division and Major Vessel Repair

CPT-33824-ADULT-DUCTUS-OR-INTERARTERIAL-OPENING-REPAIR

CPT 33824: Repair of Major Vessels Ductus or Interarterial Opening

CPT-33840-AORTIC-STRICTURE-EXCISION-PRIMARY-ANASTOMOSIS

CPT 33840: Excision of Aortic Stricture with Primary Anastomosis

CPT-33845-AORTIC-STRICTURE-EXCISION-TISSUE-GRAFT-REPAIR

CPT 33845: Excision of Aortic Stricture with Tissue Graft Repair

CPT-33851-AORTIC-NARROWING-EXCISION-PDA-REPAIR

CPT 33851: Excision of Aortic Narrowing, ± PDA Repair

CPT-33852-AORTIC-ARCH-REPAIR-NO-CPB

CPT 33852: Aortic Arch Repair Without Cardiopulmonary Bypass

Showing 1–10 of 11

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work required is substantially greater than typical for `33800` (document reasons and extent).
`23`	Unusual anesthesia	When medically necessary anesthesia services are provided under unusual circumstances unrelated to the procedure complexity.
`26`	Professional component	When reporting only the professional component of a related diagnostic service (e.g., professional reading of imaging) associated with perioperative care.
`50`	Bilateral procedure	Rarely applicable; use only if bilateral separate surgical fixes are performed and payer allows bilateral reporting.
`51`	Multiple procedures	When `33800` is billed on the same day with additional distinct surgical procedures; list and sequence correctly.
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the procedure is started but discontinued due to extenuating circumstances (use with documentation).
`62`	Two surgeons	When two surgeons from different specialties perform distinct portions of the operation concurrently.
`63`	Procedure performed on infants less than 4 kg	Use when payer requires weight-based modifier for neonatal/small infant surgery.
`78`	Unplanned return to the operating room	For a related return to OR for complications during the global period.
`79`	Unrelated procedure or service during global period	(Not in provided list) Data not available in the input.
`80`	Assistant surgeon	When a qualified assistant surgeon is required and documented.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	When appropriate and payer-specific rules allow billing under the supervising surgeon.

Taxonomy Code	Specialty	Notes
207P00000X	Pediatric Cardiothoracic Surgery	Primary specialty performing aortopexy in congenital or acquired vascular compression.
2080P0005X	Pediatric Otolaryngology	Airway assessment and surgical airway management; often co-manages perioperative bronchoscopy.
2080S0010X	Pediatric Surgery	Surgical management for infants and children when pediatric cardiothoracic coverage is not available.
207L00000X	Thoracic Surgery	Adult thoracic surgeons may perform aortopexy in older children or adults with tracheal compression.
2084P0813X	Pediatric Pulmonology	Not a surgical taxonomy but frequently involved in pre- and postoperative airway evaluation and follow-up.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31575`	Bronchoscopy, rigid or flexible, with or without tracheoscopy; diagnostic	Preoperative and postoperative airway assessment to document tracheomalacia and to evaluate results of `33800`.
`32440`	Repair, tracheoplasty, with or without cartilage graft; initial	Alternative or adjunct airway surgical procedure for structural tracheal reconstruction when aortopexy alone is insufficient.
`33010`	Median sternotomy, with or without sternal closure	Surgical approach commonly used to gain access to the aortic arch during `33800` (reported if listed separately per payer rules).
`33361`	Repair of vascular ring (thoracotomy or sternotomy)	Performed when aortic arch anomaly requires concomitant vascular repair in the same surgical episode.
`51702`	Bladder catheterization, simple (for drainage)	Perioperative urinary catheter placement code often billed in the operative period for fluid management and accurate output monitoring.

Related Codes

CPT-33802-ABERRANT-VESSEL-REPAIR

CPT 33802: Surgical Repair of Aberrant Vessel

CPT-33803-REPAIR-ABERRANT-ARTERY-REANASTOMOSIS

CPT 33803: Repair of Aberrant Artery with Reanastomosis

CPT-33814-AORTOPULMONARY-DEFECT-REPAIR-CARDIOPULMONARY-BYPASS

CPT 33814: Aortopulmonary Defect Repair with Cardiopulmonary Bypass

CPT-33820-DUCTUS-OR-MAJOR-VESSEL-LIGATION-AND-CLOSURE

CPT 33820: Ligation and Closure of Ductus or Major Cardiac Vessel

CPT-33822-PEDIATRIC-DUCTUS-DIVISION-AND-VESSEL-REPAIR

CPT 33822: Pediatric Ductus Division and Major Vessel Repair

CPT-33824-ADULT-DUCTUS-OR-INTERARTERIAL-OPENING-REPAIR

CPT 33824: Repair of Major Vessels Ductus or Interarterial Opening

CPT-33840-AORTIC-STRICTURE-EXCISION-PRIMARY-ANASTOMOSIS

CPT 33840: Excision of Aortic Stricture with Primary Anastomosis

CPT-33845-AORTIC-STRICTURE-EXCISION-TISSUE-GRAFT-REPAIR

CPT 33845: Excision of Aortic Stricture with Tissue Graft Repair

CPT-33851-AORTIC-NARROWING-EXCISION-PDA-REPAIR

CPT 33851: Excision of Aortic Narrowing, ± PDA Repair

CPT-33852-AORTIC-ARCH-REPAIR-NO-CPB

CPT 33852: Aortic Arch Repair Without Cardiopulmonary Bypass

Showing 1–10 of 11

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

CPT 33800: Aortopexy for Tracheal Stabilization

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Billing Code Overview

CPT 33800: Aortopexy for Tracheal Stabilization

Sign up for cpt 33800 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical condition and patient population is CPT 33800 intended to address?

What diagnostic workup and specialties are typically involved before performing an aortopexy?

Which CPT modifiers are noted as potentially applicable to code 33800 and what documentation is needed?

What related CPT codes might be billed during the same surgical episode as 33800?

Which payers are referenced for coverage of CPT 33800, and does the page provide reimbursement rates or payer-specific coverage criteria?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical condition and patient population is CPT 33800 intended to address?

What diagnostic workup and specialties are typically involved before performing an aortopexy?

Which CPT modifiers are noted as potentially applicable to code 33800 and what documentation is needed?

What related CPT codes might be billed during the same surgical episode as 33800?

Which payers are referenced for coverage of CPT 33800, and does the page provide reimbursement rates or payer-specific coverage criteria?

References