Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
The procedure described by CPT® Code 33924 involves the ligation and takedown of a systemic-to-pulmonary artery shunt, which is a surgical intervention typically performed in conjunction with a congenital heart procedure. This procedure is necessary when a previously established shunt, which is a connection between a systemic artery and a pulmonary artery, needs to be closed off and removed. The ligation process entails carefully exposing the heart through a median sternotomy or thoracotomy, which are surgical approaches that allow access to the thoracic cavity. Once the heart is accessed, the shunt is meticulously exposed by dissecting the surrounding tissue and any adhesions that may have formed. The control of the shunt is achieved by placing soft rubber tubing both proximally and distally to the shunt, which helps in managing the blood flow during the procedure. Finally, suture ligatures are applied at both ends of the shunt, after which the shunt is divided and excised from the body. This procedure is listed separately in addition to the code for the primary congenital heart procedure being performed, highlighting its significance in the overall surgical management of congenital heart defects.
© Copyright 2026 Coding Ahead. All rights reserved.
The ligation and takedown of a systemic-to-pulmonary artery shunt, as described by CPT® Code 33924, is indicated in specific clinical scenarios related to congenital heart conditions. The following are the primary indications for this procedure:
The procedure for ligation and takedown of a systemic-to-pulmonary artery shunt involves several critical steps, each essential for the successful completion of the surgery:
Post-procedure care following the ligation and takedown of a systemic-to-pulmonary artery shunt involves monitoring the patient for any complications that may arise from the surgery. Patients are typically observed in a recovery area where vital signs are closely monitored. Expected recovery may include managing pain and ensuring that the patient is stable before transferring them to a regular ward. Additional considerations include assessing the patient's overall cardiac function and readiness for any subsequent procedures that may be planned as part of their ongoing treatment for congenital heart defects. Follow-up appointments are essential to evaluate the surgical site and the patient's recovery progress.
| Short Descr | REMOVE PULMONARY SHUNT | Medium Descr | LIG&TKDN SYSIC-TO-PULM ART SHUNT W/CGEN HEART | Long Descr | Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 an add-on code that must be used in conjunction with one of these primary codes.
| 33474 | MPFS Status: Active Code APC C Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass | 33475 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Replacement, pulmonary valve | 33476 | MPFS Status: Active Code APC C Illustration for Code Right ventricular resection for infundibular stenosis, with or without commissurotomy | 33477 | MPFS Status: Active Code APC C Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed | 33478 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection | 33600 | MPFS Status: Active Code APC C CPT Assistant Article Closure of atrioventricular valve (mitral or tricuspid) by suture or patch | 33602 | MPFS Status: Active Code APC C Illustration for Code Closure of semilunar valve (aortic or pulmonary) by suture or patch | 33606 | MPFS Status: Active Code APC C Illustration for Code Anastomosis of pulmonary artery to aorta (Damus-Kaye-Stansel procedure) | 33608 | MPFS Status: Active Code APC C Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery | 33610 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect | 33611 | Modifier 63 Exempt MPFS Status: Active Code APC C Repair of double outlet right ventricle with intraventricular tunnel repair; | 33612 | MPFS Status: Active Code APC C Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction | 33615 | MPFS Status: Active Code APC C Illustration for Code Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple Fontan procedure) | 33617 | MPFS Status: Active Code APC C Illustration for Code Repair of complex cardiac anomalies (eg, single ventricle) by modified Fontan procedure | 33622 | MPFS Status: Active Code APC C Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aortic outflow obstruction and aortic arch hypoplasia, creation of cavopulmonary anastomosis, and removal of right and left pulmonary bands (eg, hybrid approach stage 2, Norwood, bidirectional Glenn, pulmonary artery debanding) | 33684 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic) | 33688 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset | 33692 | Changed Code for 2025 MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Complete repair tetralogy of Fallot without pulmonary atresia; | 33694 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Complete repair tetralogy of Fallot without pulmonary atresia; with transannular patch | 33697 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Complete repair tetralogy of Fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect | 33735 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type operation) | 33736 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Atrial septectomy or septostomy; open heart with cardiopulmonary bypass | 33741 | Modifier 63 Exempt MPFS Status: Active Code APC C Transcatheter atrial septostomy (TAS) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (eg, Rashkind, Sang-Park, balloon, cutting balloon, blade) | 33745 | MPFS Status: Active Code APC C Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies, and target zone angioplasty, when performed (eg, atrial septum, Fontan fenestration, right ventricular outflow tract, Mustard/Senning/Warden baffles); initial intracardiac shunt | 33746 | Add-on Code MPFS Status: Active Code APC C Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies, and target zone angioplasty, when performed (eg, atrial septum, Fontan fenestration, right ventricular outflow tract, Mustard/Senning/Warden baffles); each additional intracardiac shunt location (List separately in addition to code for primary procedure) | 33750 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation) | 33755 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Shunt; ascending aorta to pulmonary artery (Waterston type operation) | 33762 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Shunt; descending aorta to pulmonary artery (Potts-Smith type operation) | 33764 | MPFS Status: Active Code APC C Illustration for Code Shunt; central, with prosthetic graft | 33766 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical Glenn procedure) | 33767 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional Glenn procedure) | 33770 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect | 33771 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect | 33774 | Changed Code for 2025 MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; | 33775 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with removal of pulmonary band | 33776 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with closure of ventricular septal defect | 33777 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction | 33778 | Changed Code for 2025 Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); | 33779 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with removal of pulmonary band | 33780 | MPFS Status: Active Code APC C Illustration for Code Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with closure of ventricular septal defect | 33781 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with repair of subpulmonic obstruction | 33782 | MPFS Status: Active Code APC C Illustration for Code Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); without coronary ostium reimplantation | 33783 | MPFS Status: Active Code APC C Illustration for Code Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); with reimplantation of 1 or both coronary ostia | 33786 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Total repair, truncus arteriosus (Rastelli type operation) | 33917 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of pulmonary artery stenosis by reconstruction with patch or graft | 33920 | MPFS Status: Active Code APC C CPT Assistant Article Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery | 33922 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Transection of pulmonary artery with cardiopulmonary bypass | 33925 | MPFS Status: Active Code APC C Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass | 33926 | MPFS Status: Active Code APC C Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass | 33935 | MPFS Status: Restricted APC C PUB 100 Illustration for Code Heart-lung transplant with recipient cardiectomy-pneumonectomy | 33945 | MPFS Status: Restricted APC C PUB 100 CPT Assistant Article Heart transplant, with or without recipient cardiectomy |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2015-01-01 | Note | AMA Guidelines changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 1996-01-01 | Added | First appearance in code book in 1996. |
Get instant expert-level medical coding assistance.