CPT 33824 Repair of Adult PDA — Reimbursement | OpenPayer

Summary & Overview

CPT 33824: Repair of Major Vessels Ductus or Interarterial Opening

CPT code 33824 denotes an open surgical repair of an abnormal opening between the major vessels leaving the heart, accomplished by dividing the ductus or opening and sewing together the resulting vessel stumps for adult patients. This high-acuity cardiac surgical procedure has implications for hospital resource use, operative coding accuracy, and payer coverage determinations across the country. Key national payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise clinical and billing profile of the procedure, understand the typical settings where the procedure is performed, and find context for benchmarking and reimbursement policy considerations. The publication outlines relevant billing practice elements, common modifier usage (provided as reference), and areas where coding clarity affects claims processing and payment. It also summarizes clinical context relevant to coding—patient age range, operative approach, and likely service line—so coding and compliance teams can align clinical documentation with claim submission. Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and payer-specific rates are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare33824CPTcardiac-surgeryvascular-ductus-repairinpatient-surgeryoperating-roomadult-patients

Billing Code Overview

CPT code 33824 describes surgical repair of an opening between the major blood vessels leading from the heart by dividing the ductus between the vessels and suturing the vessel stumps. This procedure is reported for patients 18 years old and older.

Service type: Open surgical cardiac repair of a vascular ductus or inter-arterial opening
Typical site of service: Hospital operating room, often performed by cardiothoracic or cardiovascular surgeons during inpatient or same-day surgical admission

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 45-year-old patient presents with a patent ductus arteriosus (PDA) diagnosed in adulthood after evaluation for exertional dyspnea and a continuous ‘machinery’ murmur. Preoperative workup includes transthoracic echocardiography confirming a hemodynamically significant PDA with left-to-right shunt and evidence of volume overload of the left heart. The cardiothoracic surgical team schedules an elective open surgical repair in an operating room with cardiopulmonary bypass on standby for adults when transcatheter closure is not feasible due to anatomy or calcification.

Perioperative workflow: pre-op evaluation by cardiology and anesthesia, informed consent, baseline labs and imaging, intraoperative general anesthesia and median sternotomy or left thoracotomy approach, surgical division of the ductus with oversewing of the proximal and distal stumps, hemostasis, chest tube placement, and standard postoperative monitoring in a step-down or intensive care unit. Postoperative documentation includes intraoperative findings, method of repair, estimated blood loss, implants if any, and discharge instructions with cardiology follow-up.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when documented work, time, or technical difficulty substantially exceeds typical for `33824`.

CPT 33853: Aortic Arch Repair With Graft and Cardiopulmonary Bypass

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

CPT 33852: Aortic Arch Repair Without Cardiopulmonary Bypass

CPT-33800-AORTOPEXY-TRACHEAL-STABILIZATION

CPT 33800: Aortopexy for Tracheal Stabilization

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

CPT 33851: Excision of Aortic Narrowing, ± PDA Repair

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

CPT 33814: Aortopulmonary Defect Repair with Cardiopulmonary Bypass

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

CPT 33822: Pediatric Ductus Division and Major Vessel Repair

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

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

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

CPT 33845: Excision of Aortic Stricture with Tissue Graft Repair

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

Showing 1–10 of 11

Taxonomy Code	Specialty	Notes
`208100000X`	Cardiothoracic Surgery	Primary specialty performing adult PDA surgical repair.
`208600000X`	Thoracic Surgery	Thoracic surgeons may perform the open approach via thoracotomy.
`207RG0400X`	Cardiovascular Disease (Adult)	Cardiology provides preoperative and postoperative management and diagnostics.
`208D00000X`	General Surgery	May assist or perform in settings without cardiothoracic specialists.
`340600000X`	Anesthesiology	Provides intraoperative anesthesia and perioperative pain management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q25.0`	Patent ductus arteriosus	Primary diagnosis indicating persistent ductus arteriosus in adults requiring surgical repair such as `33824`.
`I34.9`	Nonrheumatic mitral valve disorder, unspecified	May coexist with volume overload and be assessed during preoperative workup.
`I50.9`	Heart failure, unspecified	Chronic volume overload from a significant PDA can lead to heart failure symptoms necessitating repair.
`I27.9`	Pulmonary heart disease, unspecified	Long-standing left-to-right shunt can produce pulmonary vascular changes; relevant to surgical risk assessment.
`Z95.2`	Presence of prosthetic heart valve	Relevant for perioperative planning if the patient has prior cardiac prostheses; impacts antibiotic prophylaxis and operative approach.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99223`	Initial hospital care, typically 70 minutes or more	Preoperative inpatient evaluation by the admitting physician prior to `33824`.
`33140`	Closure of patent ductus arteriosus; surgical ligation, older child/adult (alternative code for PDA closure via device or ligation)	Alternative surgical approach codes sometimes considered; documents anatomic approach differences when coding alternatives.
`93580`	Diagnostic catheterization with or without hemodynamic measurements and angiography	May be performed preoperatively to define anatomy or for transcatheter closure planning instead of open `33824`.
`99291`	Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes	Postoperative critical care management in the immediate postoperative period after `33824` when clinically indicated.
`99238`	Hospital discharge day management; 30 minutes or less	Documentation and billing for discharge following hospitalization for `33824`.

OpenPayer