CPT 92933: Coronary Atherectomy With Intracoronary Stent

CPT 92933 covers coronary atherectomy performed with stent placement in a single major coronary artery and its branches. It sits near the top of the per-vessel hierarchy, and its errors come from billing the components it already contains.

What CPT 92933 covers

92933 is percutaneous transluminal coronary atherectomy with intracoronary stent placement, with coronary angioplasty when performed, in a single major coronary artery and/or its branch(es), as revised for 2026. Atherectomy performed without a stent in that vessel is 92924 instead.

Three services in one code for that vessel: atherectomy, stent, and angioplasty. Nothing in that list is separately reportable for the same vessel.

What changed for 2026

The PCI codes were restructured this year, and claims built on the old structure will not survive:

• The additional-branch add-on codes were deleted, including 92921, 92925, 92929, 92934, 92938 and 92944. Do not report them for dates of service in 2026.
• The base codes were revised to read "branch(es)", so typical additional branch work within the same major coronary artery is now included in the base code rather than billed separately.
• 92930 is new, for stenting of two or more distinct coronary lesions with two or more stents deployed in two or more coronary segments, or a bifurcation lesion requiring angioplasty and/or stenting in both the main artery and the side branch. 92928 was narrowed to match: it now reads one lesion involving one or more coronary segments, and is used for a single lesion regardless of the number of stents or segments.
• 92945 is new, for revascularization of a chronic total occlusion by combined antegrade and retrograde approaches. It sits alongside the existing 92943, which remains the code for a CTO treated by the antegrade approach alone. The CTO codes already include any combination of stent, atherectomy and angioplasty, so those codes are not added for the same occlusion.
• "Coronary segments" are now formally defined. CPT adopted the 29-segment anatomical model used by the National Cardiovascular Data Registry CathPCI database, so documentation has to identify the segment treated, not just the vessel.
• Coronary thrombolysis codes 92975 and 92977 were deleted.

Vessel rules and modifiers

PCI codes are reported per major coronary artery, and the vessel has to be identified on the claim:

• LD: left anterior descending.
• LC: left circumflex.
• RC: right coronary.
• LM: left main.
• RI: ramus intermedius.

One base code per major vessel treated. A second major vessel takes its own base code with its own vessel modifier. Branches within the same major vessel are now part of the base code rather than a separate line. CPT counts up to two branches of the left anterior descending (diagonals), left circumflex (marginals) and right (posterior descending, posterolaterals); the left main and ramus intermedius have none.

Work in a native coronary artery can be reported separately from work performed through a bypass graft, and work on separate lesions in different major arteries is separately reportable.

Where more than one intervention type is performed in the same vessel, report the single most intensive service for that vessel rather than stacking codes. Where a single lesion bridges two vessels but is treated with one intervention, only one code is reported.

The wider family beyond these four: 92924 atherectomy without a stent, 92937 revascularization of or through a bypass graft, 92943 and 92945 for chronic total occlusions.

Reimbursement context

The PCI codes were restructured for 2026, so figures quoted from earlier years no longer apply.

Medicare pays for this code under the Physician Fee Schedule, and the amount depends on where you practise. Each code carries relative value units for physician work, practice expense and malpractice, each adjusted by a geographic practice cost index (GPCI) for the locality, and the total is multiplied by the conversion factor:

(work RVU × work GPCI + practice expense RVU × PE GPCI + malpractice RVU × MP GPCI) × conversion factor

For 2026 the conversion factor is $33.4009 for practitioners who are not qualifying APM participants and $33.5675 for qualifying APM participants, as set in the CY 2026 Physician Fee Schedule final rule (CMS-1832-F; see the CMS fact sheet). Because the RVUs differ by code and the GPCIs differ by locality, what your practice is paid will differ from any national average. Pull the RVUs and the payment for your own locality from the CMS Physician Fee Schedule Look-Up Tool.

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.

Common denials and the exact fix

Modifier rules

• LC, LD, RC, RI, LM: required to identify the vessel treated. A missing vessel modifier is one of the most common PCI rejections, and duplicate-vessel modifiers across lines will strip the second line.
• 59 / XE / XP / XS / XU: used where a genuinely distinct service is performed, most often a diagnostic study that led to the decision to intervene. It must be supported in the note, not applied because the line denied.
• 22: increased procedural services. Requires a narrative and goes to manual review.
• 26 / TC: applies in facility settings where the professional and technical components are billed separately.
• 78 / 79: return to the procedure room during a global period, either for a related complication or for an unrelated procedure.

NCCI bundling edits

• 92933 with 92928 or 92920 in the same vessel: both are included in the atherectomy-with-stent code.
• Deleted add-ons including 92934: not reportable for 2026.
• Access, closure and guidance are included.
• A different major vessel treated in the same session takes its own base code and vessel modifier.

Frequently asked questions

Sources

American Medical Association, CPT 2026 Professional Edition.
Centers for Medicare & Medicaid Services, National Correct Coding Initiative Policy Manual and quarterly edit tables, cms.gov.
Centers for Medicare & Medicaid Services, Physician Fee Schedule Look-Up Tool, cms.gov.
American College of Cardiology, acc.org. AAPC coding resources, aapc.com.

CPT® is a registered trademark of the American Medical Association. Code descriptors are summarised here for billing guidance and are not a substitute for the current CPT codebook. Payer rules and NCCI edits change quarterly; verify against your own payer policy before submission.

Related codes

• CPT 92928. Coronary stent, one lesion, single major vessel.
• CPT 92930. Coronary stents, two or more lesions or a bifurcation.
• CPT 92941. PCI during acute MI, culprit vessel.

Related reading

• Cardiology billing & RCM. How we scrub cardiology claims across diagnostics, cath lab, EP and remote monitoring.
• Cardiac cath billing: NCCI bundling and modifier 59. Where cath lab bundling edits bite, and when a distinct-service modifier is genuinely earned.
• TC/26 modifier errors in cardiology. The split-billing mistakes that cost diagnostic practices the most.