Did you know that inconsistent pain coding can reduce a practice’s reimbursement by up to 15% each year? It usually happens when providers treat both acute and chronic conditions but code them the same way. Payers don’t just look at what procedure you performed; they look at what kind of pain you’re managing and how your documentation supports it.
Every year, multiple changes to cardiology billing occur, affecting billing revenue. Understanding these cardiology CPT codes’ changes is very important for accurate billing and smooth reimbursement. In the guide below, we have covered the most important updates in cardiology billing. Cardiologists must be aware of these changes because they will take effect from 1st of January 2026.
The cardiology CPT codes set of 2026 change had 418 total changes, 288 new codes, 46 descriptions revised, and 84 deletions. Most of these are cardiology-related as they touch upon diagnostic, interventional, and electrophysiology services. The key subjects are new remote monitor codes, augmented intelligence (AI) in cardiology, and a total redesign of leg revascularization. For your ease, we have listed all the new cardiology billing codes below.
Two new Category I E/M codes expand RPM services. 99445 covers device supply with daily recording/transmission for 2–15 days in a 30-day period (previously, at least 16 days were required), and 99470 covers RPM treatment management requiring at least one real-time patient/caregiver interaction, for the first 10 minutes per month (down from the prior 20-minute threshold).
Two new Category I codes were added for complex coronary stenting and chronic total occlusions (CTO). Code 92X01 (final code number pending) describes complex intracoronary stent placement (e.g., multiple lesions or bifurcation stenting beyond what single-vessel code 92928 covers). Code 92X02 (pending final number) describes percutaneous revascularization of a CTO with combined antegrade and retrograde approaches. These additions capture higher resource use in complex PCI cases.
A completely new code family (46 codes) was introduced for endovascular leg revascularization procedures, replacing the old femoropopliteal/tibial angioplasty/stent/atherectomy codes. The new cardiology CPT codes span 37254–37299 and provide more granular definitions by vessel and technique. Example: separate primary codes now exist for different arterial territories and for various combinations of angioplasty, stenting, and atherectomy. This overhaul modernizes reporting for advanced limb ischemia interventions (reflecting outpatient shifts and new technology).
New codes for augmented intelligence (AI) diagnostic analysis of cardiology imaging were added. One Category I code (number to be finalized, placeholder 75XX6) was approved to report AI-based quantification of coronary plaque on cardiac CT angiography. This code (covering platforms by HeartFlow, Cleerly, Elucid, etc.) graduated from temporary status to Category I, reflecting its established clinical use in evaluating CAD risk. In addition, two new Category III codes – 0992T and 0993T – now describe AI-powered analysis of perivascular fat on coronary CT (CaRi-Heart®) to assess cardiac risk. Code 0992T is used when the AI analysis of perivascular fat is performed without a concurrent heart CT scan, and 0993T is used when the analysis is done with a concurrent cardiac CT, both including a physician’s interpretation and report.
A new Category III code was implemented for AI-assisted cardiac diagnostics via wearable/recording devices. 0962T was added to report assistive algorithmic analysis of acoustic and ECG recordings for cardiac dysfunction (e.g., detecting reduced ejection fraction, heart murmurs, or atrial fibrillation from a digital stethoscope + ECG device), with physician interpretation. This code enables tracking the use of AI algorithms (such as Eko’s SENSORA™) for early heart failure and arrhythmia detection outside traditional imaging.
The primary PCI Cardiology CPT codes 92920, 92924, 92928, 92933, 92937, 92941, 92943 were revised to reflect the elimination of separate add-on codes for additional branch vessels. Descriptor and guideline updates ensure that a single primary code describes a complete coronary intervention in one vessel/territory, and new definitions accommodate the complexity captured by the two new PCI codes above. In practice, this means the main coronary angioplasty, atherectomy, stenting, etc., codes now include typical additional branch work, instead of requiring separate add-on codes.
There were slight changes to the codes 92973 (coronary mechanical thrombectomy) and 93571 (intravascular Doppler flow measurement) descriptors/guidelines. These were more editorial changes to ensure that the codes were updated to close to current practice and reorganized PCI family (e.g. when these can be reported in conjunction with the new PCI codes). The RVU of 92973 and 93571 was also reevaluated in 2026 with respect to recent surveys; nevertheless, the definitions of the billing codes were updated only with words.
The RPM service codes were updated alongside the new short-duration codes. 99453 (initial setup/education for physiologic monitoring) had a descriptor tweak to clarify it is an initial service and no longer tied to a ≥16-day data requirement. 99454 (device supply and data transmission) was revised to specify “16–30 days” of monitoring per period (replacing the prior “each 30 days” language), distinguishing it from the new 99445, which covers shorter monitoring periods. 99457 (RPM treatment management, 20-minute) was also revised in guidelines to reinforce that at least one live interactive communication is required each month. This aligns 99457 with new code 99470 and clarifies usage if a provider manages 20+ minutes in a month (they can still use 99457 for the full 20-minute service, whereas 99470 is for shorter management).
92921, 92925, 92929, 92934, 92938, 92944 were deleted. These were the add-on codes for each additional coronary artery/branch in angioplasty, atherectomy, stent, etc. Since CPT 2026 consolidates branch interventions into the primary PCI codes or new complex PCI codes, these add-on codes are no longer used.
92975 and 92977 were deleted in 2026. These Category I codes (for intracoronary thrombolytic infusion therapy during catheterization, initial and each additional day) had become rarely utilized and have been removed, streamlining the cardiac cath code set.
37220 – 37235 (the entire previous code series for peripheral endovascular revascularization in the leg arteries) were deleted. These old codes, which covered iliac/femoral-popliteal/tibial angioplasty and stenting/atherectomy, have been replaced by the new expanded code range 37254–37299 noted above. All related prior guidelines were also retired as the coding paradigm for these procedures is revamped.
(Related for cardiovascular surgeons/radiologists) 75956–75959 were deleted in 2026. These represented imaging supervision/interpretation for certain endovascular aortic repair extensions, which have been bundled into primary surgical codes or made obsolete by new endograft technology. (While not core cardiology, their deletion is part of the vascular code updates.)
No cardiology E/M or electrophysiology codes were deleted for 2026. (For completeness: codes in other specialties, like 0042T for cerebral perfusion and 55700 for prostate biopsy, were deleted but are outside cardiology.) The deletions listed above capture all significant cardiology-related removals in the CPT 2026 update.
Although the 2026 changes to cardiology CPT codes may seem confusing, but your practice will eventually benefit from them. If you’re not cautious, these modifications, which represent new approaches to patient care and technology utilization, may have an impact on your billing.
For instance, remote monitoring codes now contain more real-time patient contacts and span shorter time periods. This shift is significant because it demonstrates the increasing integration of technology into cardiac treatment. Additionally, more complicated operations like addressing persistent blockages and coronary stenting have new codes. This is due to the fact that these therapies need more time and resources; therefore, accurate tracking is crucial.
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