2025 CPT code 33766
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Shunt; superior vena cava to pulmonary artery for flow to one lung (classical Glenn procedure).
Modifiers may apply based on circumstances (e.g., 51 for multiple procedures, 59 for distinct procedural service).Refer to CPT guidelines and individual payer guidelines.
The procedure is medically necessary to improve systemic oxygenation and reduce the workload on the single ventricle in patients with single-ventricle congenital heart defects.It's a palliative step in the surgical management and a prerequisite for a definitive Fontan repair in some cases.
The surgeon performs the procedure, including prepping and anesthetizing the patient, opening the chest, placing the patient on cardiopulmonary bypass, occluding and incising the relevant vessels, creating the anastomosis, stopping bleeding, and closing the chest.Post-operative care may be performed by other medical professionals.
In simple words: The doctor creates a connection between a large vein (superior vena cava) and a lung artery (pulmonary artery) so that blood from the upper body goes directly to the lungs to get oxygen, without going through a part of the heart that doesn't work properly.
This procedure involves surgically creating a shunt between the superior vena cava and the right pulmonary artery, diverting deoxygenated blood from the upper body directly to the lungs for oxygenation, bypassing a defective right heart chamber.The procedure may involve cardiopulmonary bypass, occlusion of the superior vena cava and right pulmonary artery, and creation of an end-to-end anastomosis between these vessels.It is a palliative procedure often used in patients with single-ventricle congenital heart defects.
Example 1: A 6-month-old infant with hypoplastic left heart syndrome undergoes a classical Glenn procedure (33766) to improve oxygenation and reduce the workload on the single functioning ventricle. This is staged before a Fontan procedure., A child with tricuspid atresia undergoes a modified Glenn procedure (33766) to create a bidirectional shunt between the superior vena cava and the pulmonary arteries. This improves blood flow to both lungs and is a palliative measure before Fontan repair., A patient presents with single ventricle physiology secondary to other congenital heart defects. They are candidates for a staged surgical approach consisting of Glenn (33766) and Fontan procedures to establish systemic to pulmonary blood flow.
Pre-operative echocardiogram, cardiac catheterization (if performed), operative report detailing the technique and location of the shunt, post-operative echocardiogram, and any complications encountered.
** The code 33766 describes the classical unidirectional Glenn shunt, shunting blood from the SVC to the right pulmonary artery.Modified or bidirectional Glenn shunts supply blood to both lungs and may be separately documented or accounted for through other codes. The procedure is typically performed in infants and young children.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Modifier TC rule: The TC modifier is not applicable to this procedure.
- Specialties:Cardiothoracic Surgery, Pediatric Cardiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center