CPT 92920 Billing: Coronary Angioplasty

Mukesh MakwanaFounder & CEO · Hands-on medical billing & RCM across 11 specialties · Reviewed September 28, 2026

CPT 92920 covers balloon angioplasty of a single major coronary artery and its branches. For 2026 it absorbed the additional-branch work that used to be billed separately, which means claims built on the old add-on structure now reject.

What CPT 92920 covers

92920 is percutaneous transluminal coronary angioplasty of a single major coronary artery and/or its branch(es), as revised for 2026. It covers balloon dilatation without stent placement or atherectomy in that vessel.

It is the least intensive of the PCI base codes. Where a stent was placed or atherectomy performed in the same vessel, a higher code in the family replaces 92920 for that vessel rather than being billed alongside it.

What changed for 92920 in 2026

92920 was revised to read "and/or its branch(es)", so balloon angioplasty in the branches of the treated artery is now part of the single line, and the add-on 92921 that used to carry additional branches was deleted. A 2026 claim still carrying 92921 rejects. The rest of the restructure, including the new 92930 and 92945 and the 29-segment model, is in the full 2026 PCI change list on the CPT 92928 guide.

Vessel modifiers on a 92920 claim

Report 92920 once per major coronary artery treated with balloon angioplasty alone, with the vessel modifier on the line: LD, LC, RC, LM or RI. Balloon work in the branches of that same artery sits inside the one 92920 line for 2026. If a stent was placed or atherectomy performed in that artery, the higher code replaces 92920 for the vessel. See the full vessel and branch rules on the CPT 92928 guide.

Reimbursement context

2026 Medicare RVUs for CPT 92920

CPT 92920: 2026 Medicare RVUs (national, before GPCI)
Line	Work	PE, non-facility	PE, facility	Malpractice	Total, non-facility	Total, facility
Global (no modifier)	8.14	NA	1.54	1.91	NA	11.59

Source: CMS CY 2026 PFS Relative Value File, RVU26D (October release, published 08/26/2026). RVUs are national and unadjusted; commercial payers set their own rates.

In the 2026 CMS relative value file, CPT 92920 carries 8.14 work RVUs and 11.59 total RVUs. The non-facility column is NA: CMS values this procedure only for a facility setting such as a hospital. Its PC/TC indicator is 0: CMS treats it as a physician service, so modifiers 26 and TC do not apply in any setting. Its global period is 000: related work on the day of the procedure is included, with no postoperative days. Across the PCI base codes, work RVUs run from 8.14 (92920) to 15.00 (92945), so 92920 carries the lowest physician work in its group.

To turn RVUs into payment, each component is multiplied by your locality's geographic practice cost index, the three are added, and the sum is multiplied by the 2026 conversion factor: $33.4009, or $33.5675 for qualifying APM participants (CMS-1832-F; CMS fact sheet). The CMS Physician Fee Schedule Look-Up Tool runs that calculation for your locality.

Documentation requirements

The vessel treated, named specifically, and every branch involved.
The coronary segment(s) treated, per the 29-segment model CPT adopted for 2026. Segment-level detail is what separates one lesion from two, and therefore 92928 from 92930.
Lesion location, length and percentage stenosis before and after, and the number of stents deployed.
Devices used, including stent type, size and number.
The clinical indication for intervention, including ischemia evidence where required by payer policy.
Whether a diagnostic study preceded the intervention in the same session, and if so, why it was necessary and not already available.
Contrast volume, fluoroscopy time and any complications.
A signed procedure note naming each intervention performed per vessel.

Medicare contractor billing articles. Each Medicare Administrative Contractor publishes its own billing and coding articles for this service, and the covered diagnoses differ by jurisdiction. Active examples in the CMS Medicare Coverage Database, checked September 28, 2026: A56823 (Percutaneous Coronary Intervention, Wellpoint Federal) and A57479 (Percutaneous Coronary Interventions, WPS). Use the article from the contractor that processes your claims.

Common denials and the exact fix

Deleted add-on code billed for additional branches

92921 no longer exists. Claims still carrying it for 2026 dates of service reject.

Fix: remove the add-on line. Branch work within the same major vessel is now inside 92920. Update the charge master and any scrub rule that still references the deleted code.

Angioplasty billed alongside a stent in the same vessel

Stent placement codes already include angioplasty performed in that vessel.

Fix: report the stent code for that vessel and delete the 92920 line. Report the single most intensive service per vessel.

Missing or duplicated vessel modifier

A PCI line without a vessel modifier cannot be adjudicated, and two lines carrying the same vessel modifier read as a duplicate.

Fix: attach the correct modifier to each line and confirm no two lines claim the same vessel.

Diagnostic catheterization billed in the same session without support

A diagnostic study in the same session is separately reportable only when it prompted the decision to intervene and was not already available.

Fix: document that reasoning explicitly in the note before appending a distinct-service modifier.

CO-50: indication does not support intervention

Payers increasingly require documented ischemia or a qualifying lesion severity for elective PCI.

Fix: include the functional or anatomic evidence in the record and check your MAC's PCI billing article.

Modifier rules

LC, LD, RC, RI, LM: required on every 92920 line to identify the vessel treated. A missing vessel modifier is one of the most common PCI rejections, and two lines carrying the same vessel modifier read as a duplicate.
59 / XE / XP / XS / XU: for a genuinely distinct service, most often a diagnostic study that led to the decision to intervene, and only when the note supports it. Note that a stent or atherectomy code in the same vessel already includes the angioplasty, so no modifier makes both lines payable.
26 / TC: not used. CMS gives CPT 92920 a PC/TC indicator of 0 (physician service), so it is billed without a component modifier in every setting, including the hospital.
22: increased procedural services on 92920. Requires a narrative and goes to manual review.
78 / 79: a return to the procedure room during the 92920 global day, for a related complication or an unrelated procedure.

NCCI bundling edits

92920 with a stent or atherectomy code in the same vessel: report the most intensive service only.
Deleted add-ons 92921, 92929, 92934, 92944: not reportable for 2026 dates of service.
Diagnostic catheterization in the same session: separately reportable only where the note supports it.
Access, closure and guidance are included in the intervention.
Edits update quarterly, so re-check before assuming a pairing is payable.

Frequently asked questions

Can I still bill 92921 for an additional branch in 2026?

No. The additional-branch add-on codes including 92921 were deleted for 2026, and the base codes were revised to read branch(es) so that typical additional branch work is now included in the base code. Claims carrying the deleted add-on will reject, and charge masters that still list it should be updated.

Can 92920 be billed with a stent code for the same vessel?

No. Stent placement codes already include angioplasty performed in that vessel. Report the single most intensive service per major coronary artery. If a different major vessel was treated with angioplasty alone, that vessel takes its own 92920 line with its own vessel modifier.

How many PCI codes can be billed for one procedure?

One base code per major coronary artery treated, each with its own vessel modifier. Branches within the same major vessel are included in that vessel's base code for 2026, so multiple lines are appropriate only when multiple major vessels were treated.

Sources

American Medical Association, CPT 2026 Professional Edition.
Centers for Medicare & Medicaid Services, CY 2026 PFS Relative Value File RVU26D (October release): RVUs, PC/TC indicator and global period for CPT 92920.
Centers for Medicare & Medicaid Services, CY 2026 Physician Fee Schedule final rule, CMS-1832-F: conversion factors.
Centers for Medicare & Medicaid Services, National Correct Coding Initiative Policy Manual for Medicare Services and quarterly procedure-to-procedure edit tables.
Society for Cardiovascular Angiography & Interventions, 2026 PCI CPT Coding Changes, and the American College of Cardiology Coding Corner overview of new CPT codes for 2026.
Medicare Coverage Database billing and coding articles A56823, A57479.

CPT® is a registered trademark of the American Medical Association. Payer policy and NCCI edits change quarterly, so check your own contractor before submission. How we verify this guidance.

Related codes

CPT 92928. Coronary stent, one lesion, single major vessel.
CPT 92933. Coronary atherectomy with stent, single major vessel.
CPT 92941. PCI during acute MI, culprit vessel.

More cardiology code guides

CPT 93798. Cardiac rehab session with ECG monitoring.
CPT 93306. Complete TTE with spectral and color flow Doppler.
CPT 93307. Complete TTE without Doppler.
CPT 93308. Limited or follow-up echo.

CPT 92920: Percutaneous Transluminal Coronary Angioplasty