2025 CPT code 33416
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on Cardiac Valves Surgical Procedures on the Cardiovascular System Feed
Ventriculomyotomy or ventriculomyectomy for idiopathic hypertrophic subaortic stenosis (e.g., asymmetric septal hypertrophy).
Modifiers may be applicable depending on the circumstances of the procedure (e.g., modifier 51 for multiple procedures, modifier 62 for two surgeons).
Medical necessity is established by the presence of significant symptoms (e.g., angina, syncope, dyspnea) attributable to hypertrophic obstructive cardiomyopathy and documented by echocardiography or cardiac catheterization.The procedure is medically necessary to improve left ventricular outflow tract obstruction and alleviate symptoms.
The surgeon prepares the patient, performs the sternotomy, opens the pericardium, accesses the aorta, removes the stenotic muscle, and closes the incision.Cardiopulmonary bypass is typically utilized.
In simple words: The doctor makes an incision in the heart muscle to treat a condition where the heart's left ventricle is enlarged and blocks blood flow.This may involve removing some of the heart muscle. The patient's heart and lungs are temporarily supported by a machine during the surgery.
The provider performs a ventriculomyotomy or ventriculomyectomy, an incision into the muscular heart wall, which may include removing part of the muscle. This procedure is used to treat idiopathic hypertrophic subaortic stenosis, a disorder that causes hypertrophy or enlargement of the left ventricle, leading to obstructed blood flow.The procedure typically involves prepping and anesthetizing the patient, placing them on cardiopulmonary bypass (CPB), opening the chest (usually via sternotomy), opening the pericardium (possibly removing a portion for later use as a patch), opening the aorta above the aortic valve, removing stenotic ventricular muscle and tissue, and closing the chest incision.
Example 1: A 55-year-old male presents with symptoms of severe shortness of breath and chest pain.Echocardiography reveals significant asymmetric septal hypertrophy causing outflow tract obstruction.A ventriculomyotomy is performed to relieve the obstruction., A 60-year-old female with a history of idiopathic hypertrophic subaortic stenosis undergoes a ventriculomyectomy to remove a significant portion of hypertrophied septal muscle.Cardiopulmonary bypass is used., A 70-year-old male with severe hypertrophic cardiomyopathy and symptomatic outflow obstruction undergoes a combined procedure including a ventriculomyotomy and mitral valve repair.The ventriculomyotomy is coded separately.
Preoperative echocardiogram demonstrating significant hypertrophic obstructive cardiomyopathy, operative report detailing the extent of myotomy/myectomy, and postoperative echocardiogram documenting improvement in outflow tract gradient.
** This code is specifically for the surgical myotomy or myectomy.Percutaneous transcatheter septal reduction therapy (code 93583) is a separate procedure.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Specialties:Cardiothoracic Surgery
- Place of Service:Inpatient Hospital