Cardiology CPT Codes 2026 New Code Revisions and Billing Changes

Last Updated on August 31, 2026

Cardiology practices face several important CPT coding changes in 2026, particularly across percutaneous coronary intervention, lower extremity revascularization, coronary plaque analysis, baroreflex activation therapy, and cardiovascular monitoring.

The changes affect more than code selection. New, revised, and deleted codes require cardiology teams to update procedure documentation, charge capture, authorization mappings, and billing rules. The American College of Cardiology identifies PCI, lower extremity revascularization, coronary plaque assessment, and cardiovascular device services among the major coding areas affected in 2026.

For cardiology practices and hospital cardiovascular programs, understanding what each code represents is the first step toward preventing coding errors and reimbursement delays.

Key Cardiology CPT Code Changes for 2026

The 37254 through 37299 family contains 46 codes, so selection depends on the vascular territory, lesion complexity, vessel treated, and intervention rather than a single procedure descriptor.

CPT 92930 for Complex Coronary Stent Placement

CPT 92930 is new for 2026 and reports complex intracoronary stent placement involving either multiple distinct coronary lesions or qualifying bifurcation treatment.

In practical terms, the code applies when two or more distinct coronary lesions require stents in separate coronary segments or when a bifurcation requires intervention in both the main vessel and side branch.

Documentation should clearly identify:

• Major coronary artery and branches treated
• Number and location of lesions
• Coronary segments involved
• Number of stents deployed
• Bifurcation treatment when applicable

The number of stents alone does not establish CPT 92930. The procedural documentation must support the qualifying lesion or bifurcation complexity.

For complex coronary procedures, specialty-focused professional fee coding can help ensure the procedural note supports the CPT code selected.

CPT 92945 for Chronic Total Occlusion Revascularization

CPT 92945 reports revascularization of a chronic total coronary occlusion using both antegrade and retrograde approaches. The service may incorporate angioplasty, atherectomy, and stent placement performed as part of the CTO revascularization.

The operative report should document:

• Chronic total occlusion
• Coronary vessel treated
• Antegrade approach
• Retrograde approach
• Interventions performed

AnnexMed operational observation: Complex PCI denials can begin when the clinical work is documented but the specific coding distinction is not. For CPT 92945, describing CTO treatment without clearly documenting both approaches may leave the code unsupported.

Deleted and Revised PCI Codes for 2026

Several PCI codes were deleted as part of the 2026 restructuring.

• 92921
• 92925
• 92929
• 92934
• 92938
• 92944
• 92975
• 92977

The deletion of the additional-branch codes reflects revisions to the primary PCI descriptors so branch treatment can be captured within the appropriate base code when requirements are met.

Several established codes also received descriptor changes. CPT 92973 continues to report mechanical coronary thrombectomy as an add-on service, while 93571 and 93572 report physiologic assessment of coronary vessels when the applicable requirements are met.

CPT 37254 Through 37299 for Lower Extremity Revascularization

Lower extremity revascularization underwent one of the largest cardiovascular CPT restructurings for 2026.

Codes 37220 through 37235 were deleted and replaced by 46 codes from 37254 through 37299.

Rather than listing all 46 individual descriptors, the new family can be understood through four vascular territories:

• Iliac
• Femoral and popliteal
• Tibial and peroneal
• Inframalleolar

Code selection further depends on whether the lesion is a stenosis or occlusion and whether treatment involves angioplasty, stenting, atherectomy, intravascular lithotripsy, or a combination of services.

This is particularly important for cardiology groups performing peripheral vascular interventions because the previous coding logic should not simply be carried forward into 2026.

Operational example: A physician may document and code a lower extremity intervention correctly under the new 37254 through 37299 family, but the claim can still deny if prior authorization was obtained using a deleted 37220 through 37235 code.

For high-value vascular procedures, prior authorization services should remain aligned with the CPT code ultimately submitted.

CPT 75577 for Coronary Plaque Assessment

CPT 75577 is a new Category I code for quantitative coronary atherosclerotic plaque assessment using software analysis of coronary CT angiography data.

It replaces Category III codes:

• 0623T
• 0624T
• 0625T
• 0626T

CPT 75577 requires software-based plaque analysis along with interpretation and reporting by the physician or other qualified healthcare professional.

Moving from Category III to Category I reporting reflects broader clinical adoption, but it does not guarantee coverage by every payer. Medical necessity, authorization, and individual coverage policies still apply.

A focused medical coding audit can help identify obsolete 0623T through 0626T mappings and other CPT transition gaps.

CPT 64654 Through 64659 for Baroreflex Activation Therapy

The 2026 code set introduces Category I reporting for baroreflex activation therapy system procedures.

• 64654 reports initial implantation of the complete BAT system, including carotid sinus lead placement and pulse generator implantation.
• 64655 reports revision or replacement of the BAT lead only.
• 64656 reports revision or replacement of the BAT pulse generator only.
• 64657 reports removal of the complete BAT system, including lead and generator.
• 64658 reports removal of the BAT lead only.
• 64659 reports removal of the BAT pulse generator only.

These codes replace previous Category III reporting for corresponding implantation, revision, replacement, and removal procedures.

Cardiology and cardiovascular surgery teams should review device documentation and chargemaster mappings so the specific component treated matches the code submitted.

CPT 0948T and 0949T for Cardiac Contractility Modulation

CPT 0948T and 0949T remain important in 2026, although they became effective July 1, 2025 rather than January 1, 2026.

• 0948T reports the professional remote evaluation, analysis, and reporting of cardiac contractility modulation system data over a monitoring period of up to 90 days.
• 0949T reports the technical component, including data acquisition, technician review, technical support, and distribution of results.

These services should be distinguished from in-person CCM device evaluation and from established pacemaker or ICD monitoring codes.

CMS also established national coverage for cardiac contractility modulation under Coverage with Evidence Development for qualifying heart failure patients participating in CMS-approved studies, making coverage requirements an important consideration alongside coding.

CPT 0981T Through 0983T for Wireless IVC Monitoring

CPT 0981T through 0983T remain relevant in 2026 after becoming effective July 1, 2025. These Category III codes report wireless inferior vena cava pressure monitoring services. 

• 0981T reports transcatheter implantation of a wireless IVC sensor for long-term hemodynamic monitoring, including associated catheterization and imaging when performed.
• 0982T reports initial remote-monitoring setup and patient education for the implanted IVC pressure sensor.
• 0983T reports ongoing remote review, analysis, interpretation, and reporting of IVC sensor data.

Because these are Category III codes for emerging technology, payer coverage should be verified before assuming separate reimbursement.

CCTA Hospital Billing Considerations in 2026

CCTA revenue-code reporting remains an important hospital billing issue in 2026, but it is not a new 2026 CPT change.

CMS removed an earlier restriction that limited cardiac CT reporting to traditional radiology revenue codes. Hospitals can use an appropriate cardiology or imaging revenue code when it accurately represents the cost center responsible for the service.

This remains particularly relevant for:

• 75572 cardiac CT for cardiac structure and morphology
• 75573 cardiac CT for congenital heart disease
• 75574 coronary CT angiography

Hospital cardiovascular programs should review charge capture and cost-center mapping so CCTA services are reported consistently with the resources used.

For hospital-based cardiology, facility coding services can support CPT, APC, modifier, and revenue-code alignment.

Medicare Cardiology Payment Changes for 2026

CMS finalized two Medicare Physician Fee Schedule conversion factors for 2026:

• $33.5675 for qualifying Advanced APM participants
• $33.4009 for nonqualifying APM participants

The $33.5675 and $33.4009 figures and 3.77% and 3.26% increases are correct. ACC independently reports the same figures and CMS’s estimated 1% cardiology impact. .

ACC also estimates a significant difference between facility and nonfacility cardiology, with facility-based services facing downward pressure while office-based services may see stronger payment changes.

The headline conversion-factor increase should therefore not be interpreted as the expected reimbursement increase for every cardiology CPT code.

Common Cardiology Coding and Denial Risks

The 2026 changes create several areas that cardiology billing teams should monitor:

• Incorrect coronary artery, branch, or lesion documentation
• Missing antegrade or retrograde CTO approach details
• Incomplete lower extremity vascular territory documentation
• Separately billing services incorporated into a primary procedure
• Unsupported modifier 59 or X modifier use
• Incorrect professional and technical component reporting
• Assuming emerging Category III services are automatically covered

When these patterns begin repeating by procedure or payer, denial management services can connect claim recovery with upstream coding correction.

Protecting Cardiology Revenue Through Accurate CPT Implementation

Accurate 2026 cardiology coding depends on translating new and revised CPT requirements into consistent clinical documentation and billing workflows.

The complexity is especially visible in PCI and lower extremity revascularization, where code selection depends on detailed procedural anatomy and technique. Emerging services such as coronary plaque assessment, baroreflex activation therapy, and wireless hemodynamic monitoring add payer coverage and device-reporting considerations.

AnnexMed’s cardiology billing services support cardiology practices and hospital cardiovascular programs with coding validation, prior authorization, claims, denial management, AR follow-up, and reimbursement review. Connecting these functions helps identify coding gaps before they become recurring payment problems.

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