CPT 33851 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 33851: Excision of Aortic Narrowing, ± PDA Repair

CPT code 33851 represents a cardiac surgical procedure to excise tissue causing aortic narrowing, with optional repair of a patent ductus arteriosus using the left subclavian artery or a prosthesis. This operation is clinically significant because aortic narrowing and associated ductal defects can cause critical cardiac and systemic circulatory compromise; appropriate coding ensures accurate capture of complex surgical care and supports quality reporting and payment processes.

Key payers considered in the national context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks and coding context, operational considerations for hospital-based cardiac surgical services, and notes on clinical indications and procedural scope. The publication covers coding nuances for billing and documentation, typical sites of service, and the clinical context that justifies use of this code. Data not provided in the input (such as payer-specific reimbursement rates, taxonomies, and related ICD-10 codes) are noted as unavailable where appropriate.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 33851aortic surgerycardiac surgerypatent ductus arteriosus repairvascular repairoperative codehospital servicessurgical procedure

Billing Code Overview

CPT code 33851 describes a surgical procedure to excise tissue that is causing narrowing of the aorta. The service may include repair of a patent ductus arteriosus when present. For the repair, the provider uses either the left subclavian artery or a synthetic prosthesis.

Service type: Surgical excision and vascular repair
Typical site of service: Hospital operating room or specialized cardiac surgical suite

Clinical & Coding Specifications

Clinical Context

A typical patient is an infant or child presenting with congenital coarctation of the aorta causing upper extremity hypertension, differential pulses, or heart failure symptoms. Diagnostic workup includes echocardiography and chest CT or MRI confirming a discrete aortic narrowing at the isthmus; evaluation also screens for an associated patent ductus arteriosus. The surgical workflow begins with preoperative cardiac anesthesia and baseline labs, crossmatch, and imaging review. The patient is taken to the operating room for open surgical repair via left thoracotomy. The surgeon excises the narrowed aortic segment and performs an end-to-end anastomosis or uses an interposition graft (prosthesis) or left subclavian artery flap/repair when indicated. If a patent ductus arteriosus is present, the provider ligates or repairs it during the same operative session. Intraoperative transesophageal echocardiography or epiaortic assessment may be used. Postoperative care occurs in a pediatric intensive care unit with hemodynamic monitoring, pain control, and follow-up imaging to confirm repair integrity and perfusion.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for the procedure (document increased complexity/operative time).

Related Codes

CPT-33802-ABERRANT-VESSEL-REPAIR

CPT 33802: Surgical Repair of Aberrant Vessel

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

CPT 33824: Repair of Major Vessels Ductus or Interarterial Opening

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-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-33853-AORTIC-ARCH-REPAIR-WITH-BYPASS

CPT 33853: Aortic Arch Repair With Graft and Cardiopulmonary Bypass

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

CPT 33814: Aortopulmonary Defect Repair with Cardiopulmonary Bypass

CPT-33803-REPAIR-ABERRANT-ARTERY-REANASTOMOSIS

CPT 33803: Repair of Aberrant Artery with Reanastomosis

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

CPT 33822: Pediatric Ductus Division and Major Vessel Repair

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Taxonomy Code	Specialty	Notes
`334U00000X`	Pediatric Cardiothoracic Surgeon	Performs congenital aortic reconstruction and PDA repair.
`207RE0101X`	Thoracic Surgery	Adult/pediatric thoracic surgeons who perform open aortic repairs.
`207RC0000X`	Cardiac Surgery	Cardiac surgeons who manage complex aortic pathology.
`2080P0004X`	Pediatric Cardiology	Provides preoperative and postoperative diagnostic and hemodynamic management (nonoperative specialty).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q25.1`	Coarctation of aorta	Primary indication for `33851`; congenital narrowing of the aorta requiring surgical excision and repair.
`Q25.0`	Patent ductus arteriosus	Frequently associated congenital lesion; may be repaired or ligated during the same operation.
`I10`	Essential (primary) hypertension	May be a presenting feature in older children or adults with undiagnosed coarctation; contributes to preoperative assessment.
`I50.9`	Heart failure, unspecified	Advanced coarctation can cause heart failure symptoms requiring surgical correction.
`Z95.2`	Presence of prosthetic heart valve	Relevant for perioperative planning and anticoagulation management if present; impacts surgical planning.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33850`	Resection of aortic coarctation, with end-to-end anastomosis or subclavian flap; without cardiopulmonary bypass	Often reported for discrete coarctation repairs; closely related technique and may be used when no prosthetic interposition is required.
`33852`	Resection of aortic coarctation with prosthetic graft interposition	Used when an interposition prosthetic graft is required instead of primary anastomosis; selected based on intraoperative technique.
`33405`	Resection and replacement, ascending aorta with prosthetic graft (separate code for different aortic level)	May be performed in conjunction when proximal aortic pathology requires repair during the same hospitalization (not typically the same operative field but relevant in complex aortic disease).
`35860`	Ligation, patent ductus arteriosus (PDA)	When a PDA is identified and ligated during the same operative session; may be reported in addition to the coarctation code if not bundled per payer rules.
`94010`	Echocardiography, transesophageal; diagnostic intraoperative or postoperative	Intraoperative or immediate postoperative echocardiography used to assess repair integrity; may be billed by cardiology/ anesthesia depending on service.