Coding Ahead
CasePilot
Medical Coding Assistant
CaseConsultant
Instant Email Coding Consultant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 33730 refers to the complete repair of total anomalous pulmonary venous return (TAPVR), which is a congenital heart defect characterized by an abnormal connection of the pulmonary veins. In a normal anatomical configuration, the pulmonary veins should drain oxygenated blood from the lungs into the left atrium of the heart. However, in TAPVR, all four pulmonary veins drain into the right atrium through an abnormal connection, leading to inadequate oxygenation of the blood and various clinical complications. TAPVR is classified into three types based on the location of the abnormal connection: supracardiac, intracardiac, and infracardiac. In supracardiac TAPVR, the pulmonary veins connect to a vertical vein that drains into the innominate vein, which subsequently empties into the superior vena cava and then into the right atrium. Intracardiac TAPVR involves the pulmonary veins draining directly into the right atrium or through the coronary sinus, which is responsible for returning blood from the heart muscle itself back to the right atrium. In infracardiac TAPVR, the pulmonary veins connect to the hepatic veins, which drain into the inferior vena cava before reaching the right atrium. All patients with TAPVR also present with an atrial septal defect (ASD), which is a hole in the wall separating the left and right atria. The surgical procedure to repair TAPVR typically involves accessing the heart through a midline sternotomy or a left anterolateral thoracotomy, establishing cardiopulmonary bypass, and initiating cardioplegic arrest to protect the heart during surgery. The repair process involves severing the abnormal connections and redirecting the pulmonary veins to the left atrium, as well as addressing the associated ASD. This complex procedure is critical for restoring normal blood flow and improving oxygenation in affected patients.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The complete repair of anomalous pulmonary venous return (CPT® Code 33730) is indicated for patients diagnosed with total anomalous pulmonary venous return (TAPVR). This condition is characterized by the following:

  • Congenital Heart Defect: TAPVR is a rare congenital defect where all four pulmonary veins drain into the right atrium instead of the left atrium.
  • Types of TAPVR: The procedure is indicated for all types of TAPVR, including supracardiac, intracardiac, and infracardiac forms.
  • Atrial Septal Defect (ASD): All patients with TAPVR present with an ASD, which necessitates surgical intervention to correct both the anomalous venous return and the septal defect.

2. Procedure

The procedure for the complete repair of TAPVR involves several critical steps, which are detailed as follows:

  • Step 1: Accessing the Heart - The surgical team gains access to the heart through a midline sternotomy or a left anterolateral thoracotomy. This approach allows for adequate visualization and manipulation of the heart structures.
  • Step 2: Establishing Cardiopulmonary Bypass - Cardiopulmonary bypass is initiated to take over the function of the heart and lungs during the surgery. This step is crucial for maintaining circulation and oxygenation while the heart is being repaired.
  • Step 3: Inducing Cardioplegic Arrest - Cardioplegic arrest is induced to protect the heart muscle from damage during the procedure. This involves administering a solution that temporarily stops the heart's activity.
  • Step 4: Identifying the Anomalous Connections - The surgeon identifies the abnormal connections of the pulmonary veins. In cases of supracardiac or infracardiac TAPVR, if the pulmonary veins are joined in a common confluence, this connection is severed.
  • Step 5: Connecting to the Left Atrium - The common pulmonary vein confluence is then connected to the left atrium, restoring the normal pathway for oxygenated blood to enter the heart.
  • Step 6: Addressing Intracardiac Connections - If there is an intracardiac connection to the right atrium or coronary sinus, the atrial septum is partially resected. A new septum is created using a patch graft to direct blood flow from the pulmonary veins to the left atrium. Alternatively, if drainage is to the coronary sinus, a tunnel may be created to facilitate this connection.
  • Step 7: Ligation of Abnormal Vessels - Any abnormal vessels that previously carried pulmonary venous blood to the supracardiac, intracardiac, or infracardiac locations are ligated (tied off) to prevent any further abnormal blood flow.
  • Step 8: Repairing the Atrial Septal Defect - Finally, the atrial septal defect is repaired as a separately reportable procedure, ensuring that the heart's structure is restored to normal.

3. Post-Procedure

Post-procedure care following the complete repair of TAPVR involves close monitoring of the patient in a critical care setting. Patients are typically observed for any signs of complications, such as bleeding, infection, or arrhythmias. Recovery may include pain management, respiratory support, and gradual mobilization. The surgical team will also monitor the patient's heart function and oxygenation levels to ensure that the repair is successful. Follow-up appointments are essential to assess the long-term outcomes of the surgery and to manage any potential residual issues related to the heart's structure or function.

Short Descr REPAIR HEART-VEIN DEFECT(S)
Medium Descr COMPLETE RPR ANOMALOUS PULMONARY VENOUS RETURN
Long Descr Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 49 - Other OR heart procedures

This is a primary code that can be used with these additional add-on codes.

33257 Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to code for primary procedure)
33259 Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (List separately in addition to code for primary procedure)
34714 Addon Code MPFS Status: Active Code APC N ASC N1 Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure)
34716 Addon Code MPFS Status: Active Code APC N ASC N1 Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure)
34833 Addon Code Resequenced Code MPFS Status: Active Code APC C CPT Assistant Article Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure)
Date
Action
Notes
2007-01-01 Changed Code description changed.
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"