33822 PDA repair Medicare reimbursement rates in Missouri

A patent ductus arteriosus is a persistent connection between the aorta and pulmonary artery. This code describes surgical repair by dividing that connection in a patient younger than 18. A congenital cardiothoracic surgeon typically performs the operation in a hospital operating room, commonly through a left thoracotomy. The operative report should establish the patient’s age and document division of the ductus, rather than ligation alone.

Report this code for the division approach in a patient under 18; age and operative technique distinguish it from the adult division code and the ligation code. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate because the anatomy is not bilateral. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.