CPT 92941 Billing: PCI for Acute MI

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

CPT 92941 covers revascularization of an acute total or subtotal occlusion during an acute myocardial infarction. It pays more than elective PCI because it reflects the emergent setting, and its denials turn on whether the record actually establishes the acute event and the culprit vessel.

What CPT 92941 covers

92941 is percutaneous transluminal revascularization of an acute total or subtotal occlusion during acute myocardial infarction, using any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, for a single major coronary artery and/or its branches, or a single bypass graft and/or its subtended branches.

Non-emergent revascularization of or through a bypass graft is 92937, not 92941.

Two points are routinely misunderstood. The descriptor is not limited to ST-elevation MI, and aspiration thrombectomy is included rather than separately reportable.

What changed around 92941 in 2026

For acute MI cases the change that matters is in the codes billed alongside 92941. The additional-branch add-ons, including 92921, 92929, 92934 and 92944, were deleted, so they can no longer carry extra work in the session; branch work within an artery is inside its base code. The codes available for a non-culprit artery also gained two new members: 92930 for multiple lesions or a bifurcation, and 92945 for a combined-approach CTO. See the full 2026 PCI change list on the CPT 92928 guide.

Vessel modifiers on a 92941 claim

92941 goes on the culprit vessel for the infarct, with that vessel's modifier. It already covers any combination of stent, atherectomy and angioplasty in that vessel, including aspiration thrombectomy when performed. Any other major coronary artery treated in the same session is reported with the appropriate elective PCI base code and its own vessel modifier. See the full vessel and branch rules on the CPT 92928 guide.

Reimbursement context

2026 Medicare RVUs for CPT 92941

CPT 92941: 2026 Medicare RVUs (national, before GPCI)
Line	Work	PE, non-facility	PE, facility	Malpractice	Total, non-facility	Total, facility
Global (no modifier)	12.40	NA	2.35	2.90	NA	17.65

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 92941 carries 12.40 work RVUs and 17.65 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); 92941 sits at 12.40.

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

Acute MI not established in the record

The premium this code carries rests on the emergent circumstance. A note that documents an occlusion without establishing the acute infarction will not hold up.

Fix: document the presenting event, the supporting ECG and biomarker findings, and the timing, alongside the angiographic finding of acute total or subtotal occlusion.

Culprit vessel not identified

92941 is reported for the vessel treated as the culprit for the infarct.

Fix: name the culprit vessel explicitly and carry the matching vessel modifier. Non-culprit vessels treated in the same session are reported with the appropriate elective PCI code and their own vessel modifiers.

Aspiration thrombectomy billed separately

It is included in 92941 when performed.

Fix: remove the separate line.

Elective PCI code used for the culprit vessel

Reporting 92928 for a culprit lesion treated during an acute infarction under-reports the service on every affected case.

Fix: route acute MI cases through a coding check that identifies the culprit vessel and applies 92941 to it.

Deleted add-on code billed for additional branches

92944 was deleted for 2026.

Fix: remove the line; branch work is inside the base code.

Modifier rules

LC, LD, RC, RI, LM: required on every 92941 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 non-culprit artery takes its own elective base code and vessel modifier, not a modifier on a second 92941 line.
26 / TC: not used. CMS gives CPT 92941 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 92941. Requires a narrative and goes to manual review.
78 / 79: a return to the procedure room during the 92941 global day, for a related complication or an unrelated procedure.

NCCI bundling edits

92941 with aspiration thrombectomy: thrombectomy is included when performed.
92941 with 92920, 92928 or 92933 for the same vessel: 92941 absorbs the intervention performed on the culprit vessel.
Non-culprit vessels: reported separately with the appropriate elective PCI code and vessel modifier.
Deleted add-ons including 92944: not reportable for 2026.
Deleted thrombolysis codes 92975 and 92977: removed for 2026.

Frequently asked questions

Is CPT 92941 limited to STEMI?

No. The descriptor covers revascularization of an acute total or subtotal occlusion during acute myocardial infarction and is not restricted to ST-elevation infarction. What matters is that the record establishes the acute infarction and the angiographic finding of acute total or subtotal occlusion in the treated vessel.

Is aspiration thrombectomy separately billable with 92941?

No. Aspiration thrombectomy is included in 92941 when performed, so a separate line duplicates work the code already covers.

How do I report non-culprit vessels treated in the same session?

92941 applies to the culprit vessel for the infarct. Any other major coronary artery treated in the same session is reported with the appropriate elective PCI base code and its own vessel modifier.

What documentation supports the acute MI premium?

The presenting event, supporting ECG and biomarker findings, timing, and the angiographic description of acute total or subtotal occlusion in the culprit vessel. Documenting the occlusion alone, without establishing the acute infarction, is the most common reason this code fails review.

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 92941.
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 92945. CTO revascularization, antegrade and retrograde.

More cardiology code guides

CPT 93798. Cardiac rehab session with ECG monitoring.
CPT 93325. Color flow Doppler add-on.
CPT 93350. Stress echo, imaging only.
CPT 93351. Stress echo including ECG monitoring and supervision.

CPT 92941: Percutaneous Revascularization During Acute Myocardial Infarction