Cardiology CPT coding has undergone several important changes in 2026. The updates affect percutaneous coronary intervention, lower-extremity revascularization, coronary CT-based plaque analysis, cardiovascular device monitoring, remote physiologic monitoring, and emerging cardiac technologies.
The changes are more than a routine annual code refresh. Several long-standing cardiovascular code families have been restructured, while new codes provide more specific ways to report complex procedures and technology-assisted cardiovascular care.
According to the American Medical Association, the full 2026 CPT code set contains 288 new codes, 46 revised codes, and 84 deletions. Among the areas specifically highlighted by the AMA are remote monitoring, AI-assisted services, and the major overhaul of lower-extremity revascularization coding.
For cardiologists, medical coders, billing teams, cardiovascular practices, and revenue cycle professionals, updating coding workflows is important because continuing to use deleted codes or failing to document the details required by new codes can lead to claim edits, prior authorization problems, undercoding, and payment delays.
Quick Summary of the Major Cardiology CPT Code Changes for 2026
| Area | 2026 Change |
| Complex PCI | New CPT 92930 |
| Chronic total occlusion PCI | New CPT 92945 |
| Additional PCI branch codes | Several codes deleted |
| Lower-extremity revascularization | CPT 37220-37235 deleted |
| New LER family | CPT 37254-37299 introduced |
| Coronary plaque assessment | New Category I CPT 75577 |
| Previous plaque-analysis codes | 0623T-0626T deleted |
| Baroreflex activation therapy | CPT 64654-64659 introduced for relevant services |
| Remote physiologic monitoring | CPT 99445 and 99470 added |
| CCM monitoring | CPT 0948T and 0949T relevant to remote interrogation |
| Wireless IVC monitoring | Category III CPT 0981T-0983T |
| AI-supported cardiac risk assessment | Category III CPT 0992T and 0993T |
The American College of Cardiology identifies PCI, lower-extremity revascularization, coronary plaque assessment, and cardiovascular monitoring as major areas affected by the 2026 update.
1. New CPT 92930 for Complex Percutaneous Coronary Intervention
One of the most significant interventional cardiology updates is the introduction of CPT 92930.
The code is intended for certain complex coronary stent procedures where treatment involves multiple distinct lesions in qualifying coronary segments or a qualifying bifurcation requiring treatment of both the main vessel and side branch.
Previously, existing PCI codes did not always distinguish this level of procedural complexity adequately.
The American College of Cardiology explains that CPT 92930 was created to better represent the resources involved in complex stent procedures beyond those represented by the standard intracoronary stent code.
Documentation becomes especially important
For CPT 92930, the procedure note should make the clinical and anatomical complexity clear. Documentation may need to establish:
- the coronary artery and branches treated;
- location and number of lesions;
- coronary segments involved;
- stents placed;
- bifurcation involvement when applicable; and
- treatment performed in the main vessel and side branch.
Simply documenting that multiple stents were used may not, by itself, support selection of the complex PCI code.
2. New CPT 92945 for Chronic Total Occlusion Revascularization
CPT 92945 is another important addition for interventional cardiology.
The new code addresses chronic total occlusion revascularization performed using combined antegrade and retrograde approaches.
The procedure may involve a combination of coronary angioplasty, atherectomy, and stent placement as part of treatment of the chronic total occlusion. ACC specifically identifies 92945 as one of the two new codes introduced to better account for complex coronary procedures.
For accurate reporting, the operative report should clearly identify the chronic total occlusion and confirm that both antegrade and retrograde techniques were used.
This distinction matters because documentation that only says “CTO PCI performed” may not provide enough information to support the more specific 2026 code.
3. Several PCI CPT Codes Were Deleted for 2026
The PCI section has also been simplified by eliminating several codes previously used for treatment involving additional coronary branches.
The following codes were deleted for 2026:
92921, 92925, 92929, 92934, 92938 and 92944.
In addition, coronary thrombolysis codes 92975 and 92977 were removed from this section.
Rather than separately reporting some additional branch services, the primary PCI code descriptions were revised so that applicable branch treatment can be reflected through the main coding structure. The introductory guidance and definitions for coronary arteries, lesions, segments, branches, and bypass grafts were also updated.
Cardiology practices should therefore ensure that old charge-master rules or EHR favorites do not continue automatically generating deleted PCI codes.
4. Major Overhaul of Lower-Extremity Revascularization Codes
The lower-extremity revascularization (LER) changes are among the largest cardiovascular coding changes in 2026.
Previous CPT codes:
37220-37235
have been deleted.
They have been replaced by 46 new codes ranging from CPT 37254 through 37299.
This is a major structural change rather than a simple code-number replacement.
Four vascular territories now play a central role
The new LER coding system distinguishes procedures according to vascular territory, including:
- Iliac
- Femoral/popliteal
- Tibial/peroneal
- Inframalleolar
The inframalleolar territory is particularly notable because it gives the coding structure a more specific way to capture interventions involving vessels below the ankle.
Code selection may also depend on factors such as:
- vessel treated;
- stenosis versus occlusion;
- angioplasty;
- stenting;
- atherectomy;
- intravascular lithotripsy;
- number of vessels treated; and
- vascular territory.
The AMA describes the change as a comprehensive modernization of the lower-extremity revascularization section designed to better reflect current treatment techniques and care delivery.
Documentation requirements for LER are more important in 2026
A strong procedure note should identify the specific vessel and vascular territory rather than simply stating that lower-extremity angioplasty or revascularization was performed.
Coders may need clear documentation of lesion characteristics, intervention type, laterality, device use, treatment outcome, and whether the lesion was successfully crossed.
MedAxiom also emphasizes documentation of the diagnostic angiography indication, vascular access, lesion type, treatment performed, vascular territory, imaging guidance, laterality, and outcome.
5. CPT 75577 for Coronary Plaque Assessment
Cardiovascular imaging also receives an important change in 2026.
CPT 75577 was established as a Category I code for quantitative assessment of coronary atherosclerotic plaque using software analysis of coronary CT angiography data.
It replaces the former Category III codes:
0623T, 0624T, 0625T and 0626T.
The American College of Cardiology confirms that 75577 replaces these temporary Category III codes beginning with the 2026 CPT structure.
The AMA also highlights coronary atherosclerotic plaque assessment as an important example of the expanding role of augmentative software and AI-supported medical services within CPT.
Why the move matters
Moving a service from Category III codes to a Category I code generally reflects greater establishment of the service in clinical practice.
However, creation of a Category I CPT code should not be interpreted as automatic coverage by every insurance carrier.
Practices should still verify:
- medical necessity;
- payer coverage;
- prior authorization;
- professional interpretation requirements; and
- documentation requirements.
6. New AI-Assisted Cardiac Risk Assessment Codes
The 2026 CPT code set also expands coding related to software-assisted cardiovascular analysis.
CMS’s 2026 update includes 0992T and 0993T for noninvasive cardiac risk assessment involving perivascular fat analysis, with different reporting depending on whether the service is performed with concurrent cardiac CT.
The AMA highlights perivascular fat analysis as one of the new AI-supported cardiovascular services represented in the 2026 CPT update.
Because these are Category III codes, payer policies may vary significantly.
7. Changes to Baroreflex Activation Therapy Coding
Cardiology teams managing patients with baroreflex activation therapy systems should also review the 2026 coding structure.
Services previously associated with device interrogation reporting through older codes have moved into a newer group represented by CPT 64654-64659.
ACC specifically notes this code family in its cardiovascular monitoring summary for 2026.
Practices using these technologies should update device-clinic billing workflows and confirm that EHR templates, charge capture systems, and payer mappings use the appropriate code for the exact service performed.
8. Cardiovascular Device and Hemodynamic Monitoring Updates
The 2026 CPT environment also includes additional codes associated with emerging cardiovascular monitoring technologies.
Cardiac contractility modulation
Codes 0948T and 0949T are relevant to remote interrogation services associated with cardiac contractility modulation systems.
Wireless IVC monitoring
Category III codes 0981T-0983T address services associated with transcatheter implantation and monitoring of wireless inferior vena cava sensors used for long-term hemodynamic monitoring.
ACC identifies these technologies as part of the evolving cardiovascular monitoring code landscape.
Because Category III codes generally represent emerging technologies, practices should not assume that every payer follows identical coverage or reimbursement policies.
9. New Remote Physiologic Monitoring Codes for 2026
Remote physiologic monitoring is not exclusively a cardiology service, but the changes are highly relevant to cardiovascular practices monitoring conditions such as hypertension and other chronic cardiovascular conditions.
Two particularly important 2026 RPM codes are:
CPT 99445 — device supply and data transmission when qualifying physiologic data is collected for 2-15 days within a 30-day period.
CPT 99470 — RPM treatment management when 10-19 minutes of qualifying management time is provided during the calendar month.
AHIMA confirms that CPT 99445 was added for the shorter 2-15-day monitoring window and CPT 99470 for shorter treatment-management duration.
Previously, the existing RPM framework often required at least 16 days of transmitted data for device-supply reporting and a 20-minute management threshold for the traditional management code.
The new codes provide more flexibility when clinically appropriate monitoring falls below those longer thresholds.
The AMA explains that the 2026 code set added several shorter-duration remote-monitoring options, including codes for 2-15 days of monitoring and shorter treatment-management intervals.
How the 2026 Cardiology CPT Changes Affect Medical Billing
The new cardiology CPT codes affect much more than code selection.
Cardiology practices should review the entire revenue cycle.
Prior authorization
An authorization obtained under a deleted 2025 code may not automatically match the CPT code billed for a 2026 date of service.
This can be particularly important for high-value PCI and peripheral vascular procedures.
Charge capture
Old charge templates may continue producing retired CPT codes unless systems are updated.
Clinical documentation
Several new code structures require more detailed information about:
- anatomy;
- vessel;
- lesion;
- vascular territory;
- procedural approach;
- intervention performed;
- device or technology used; and
- time or monitoring thresholds.
Claim edits
Payer systems and National Correct Coding Initiative edits may affect whether related services can be reported separately.
Medical necessity
A new CPT code does not automatically establish medical necessity.
Payer-specific reimbursement
Commercial insurers and Medicare may apply different coverage, authorization, modifier, and payment requirements.
Medicare Cardiology Reimbursement Changes in 2026
CPT coding changes should also be distinguished from Medicare payment-policy changes.
CMS finalized two separate Physician Fee Schedule conversion factors for 2026, reflecting whether the clinician is a qualifying participant in an Advanced Alternative Payment Model.
CMS states that the 2026 updates include statutory adjustments as well as the temporary 2.5% increase applicable during the year.
This does not mean every cardiology service receives the same reimbursement increase.
Individual payment depends on factors including:
- CPT-specific RVUs;
- work RVUs;
- practice expense;
- malpractice RVUs;
- geographic adjustment;
- facility versus nonfacility setting; and
- payer policy.
Therefore, practices should evaluate reimbursement at the individual procedure level rather than relying only on the national conversion factor.
Common Coding Risks Cardiology Practices Should Watch in 2026
The scope of the changes increases the risk of avoidable coding errors during the transition.
Common problems may include:
- continuing to report deleted 37220-37235 codes;
- selecting the wrong 37254-37299 LER code;
- failing to identify the exact vascular territory;
- incomplete documentation of coronary lesions;
- reporting CPT 92945 without evidence of both required CTO approaches;
- incorrectly reporting former PCI branch codes;
- continuing to use 0623T-0626T instead of 75577;
- failing to distinguish 99445 from 99454;
- failing to distinguish 99470 from longer-duration RPM management;
- unsupported modifier usage;
- mismatches between authorization and submitted CPT code; and
- assuming new Category III technology automatically has payer coverage.
How Cardiology Practices Can Prepare for the 2026 CPT Updates
Successful implementation should involve more than giving coders an updated codebook.
Cardiology organizations should review their:
- EHR and charge-capture templates;
- coding software;
- physician documentation templates;
- prior authorization lists;
- payer-specific policies;
- medical necessity rules;
- coding edits;
- fee schedules;
- claim-scrubbing rules; and
- denial reports.
Targeted education should also be provided to cardiologists and procedural staff because many 2026 distinctions depend on information captured in the clinical documentation before a coder ever reviews the claim.
Final Thoughts
The cardiology CPT code changes for 2026 represent one of the more substantial recent updates for interventional and technology-driven cardiovascular care.
Complex PCI receives new reporting options through CPT 92930 and 92945. Lower-extremity revascularization moves from the former 37220-37235 family to 46 new codes from 37254-37299. Coronary plaque analysis transitions to Category I CPT 75577, while new and emerging codes address cardiac monitoring, baroreflex activation therapy, remote physiologic monitoring, AI-supported cardiac risk assessment, and other cardiovascular technologies.
For cardiology practices, the most important step is not simply learning the new numbers. Coding, documentation, prior authorization, payer rules, and revenue-cycle workflows should all be aligned with the 2026 structure.
A well-prepared cardiology billing team can reduce preventable denials, improve coding accuracy, support compliance, and ensure the work performed by cardiovascular clinicians is reported appropriately.
Frequently Asked Questions
1. What are the major cardiology CPT code changes for 2026?
Major changes include new PCI codes 92930 and 92945, replacement of lower-extremity revascularization codes 37220-37235 with 37254-37299, new CPT 75577 for coronary plaque assessment, and updates involving cardiovascular monitoring, RPM, and emerging cardiac technologies.
2. What is the new complex PCI CPT code for 2026?
CPT 92930 is new for 2026 and addresses qualifying complex intracoronary stent procedures involving multiple distinct lesions or qualifying bifurcation treatment.
3. What is CPT 92945 used for?
CPT 92945 is used for qualifying chronic total coronary occlusion revascularization performed using combined antegrade and retrograde approaches.
4. Which PCI CPT codes were deleted in 2026?
Deleted PCI codes include 92921, 92925, 92929, 92934, 92938 and 92944. Codes 92975 and 92977 were also deleted from the coronary thrombolysis area.
5. What replaced CPT codes 37220-37235 in 2026?
CPT codes 37220-37235 were deleted and replaced by 46 new lower-extremity revascularization codes from 37254 through 37299.
6. What is the new CPT code for coronary plaque analysis in 2026?
CPT 75577 is the Category I code for quantitative coronary atherosclerotic plaque assessment using software analysis of coronary CTA data.
7. What happened to CPT codes 0623T-0626T?
Category III CPT codes 0623T through 0626T were deleted and replaced by CPT 75577 for the applicable coronary plaque assessment service.
8. What are the new remote patient monitoring CPT codes for 2026?
Two important RPM additions are 99445, covering qualifying device supply for 2-15 monitoring days, and 99470, covering qualifying RPM treatment-management services in the shorter 10-19-minute range.
9. Does a new CPT code guarantee Medicare or insurance coverage?
No. Creation of a CPT code does not automatically mean every payer will cover or reimburse the service. Practices should verify medical necessity, payer policies, authorization requirements, and applicable Medicare guidance.
10. When did the 2026 cardiology CPT changes become effective?
New Category I codes in the CPT 2026 code set generally became effective January 1, 2026. Practices should use the code set appropriate to the patient’s date of service.