Summary & Overview
CPT 33926: Pulmonary Artery Repair with Unifocalization
CPT code 33926 represents an advanced cardiac surgical procedure to repair pulmonary arteries and establish a single pulmonary blood supply (unifocalization) to correct arborization anomalies, performed with cardiopulmonary bypass. This procedure is clinically significant for congenital and complex pulmonary arterial malformations and is typically performed in tertiary-care, inpatient cardiac surgery settings. Nationally, accurate coding of this procedure impacts surgical case classification, hospital billing, and resource planning for high-acuity cardiac programs.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of clinical context and service setting, plus benchmarking and policy-focused content such as reimbursement benchmarks, prior authorization trends, and coding guidance for documentation and billing workflows. The publication also highlights payer coverage patterns, common billing modifiers used with high-complexity cardiac surgery, and implications for hospital revenue cycle and surgical quality reporting.
The report is intended for clinicians, hospital coding and billing professionals, and health policy analysts seeking a national-level reference for CPT code 33926, including clinical description, typical site-of-service considerations, and where to look for payer-specific policy updates and reimbursement benchmarks. Data not available in the input will be explicitly noted in relevant sections.
Billing Code Overview
CPT code 33926 describes a surgical procedure in which the provider repairs the pulmonary arteries and creates a unifocal or single pulmonary blood supply, resulting in complete repair of arborization anomalies. The procedure is performed with cardiopulmonary bypass.
Service type: Cardiac surgical procedure — pulmonary artery reconstruction with unifocalization
Typical site of service: Inpatient hospital operating room with cardiopulmonary bypass (cardiac surgery suite)
Clinical & Coding Specifications
Clinical Context
A 6-month-old infant with pulmonary atresia and major aortopulmonary collateral arteries (MAPCAs) presents for surgical unifocalization and complete repair using cardiopulmonary bypass. Preoperative assessment includes transthoracic echocardiography, cardiac catheterization to delineate pulmonary artery anatomy and MAPCAs, cross‑sectional imaging as needed, and multidisciplinary planning with pediatric cardiology, cardiothoracic surgery, anesthesia, and perfusion. Intraoperatively, the cardiothoracic surgeon performs median sternotomy, mobilizes MAPCAs and native pulmonary arteries, creates a single pulmonary blood supply (unifocalization), and repairs pulmonary artery branches on cardiopulmonary bypass. Postoperative care occurs in a pediatric cardiac intensive care unit with ventilatory support, hemodynamic monitoring, inotropic support as indicated, and follow-up imaging (echocardiography and possibly catheterization) to assess pulmonary artery flow and right ventricular function. Typical documentation includes indication, preoperative imaging/catheterization findings, detailed operative note describing unifocalization steps and cardiopulmonary bypass times, estimated blood loss, implants or patches used, and postoperative condition and plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default | Use when no special circumstance or modifier applies |