PCI CPT Codes for 2026: Coding 92920-92945 After the Branch Code Deletions

For 2026, PCI CPT codes no longer include separate codes for coronary branches. The six branch add-on codes are gone, every base code now covers a major artery and its branches, and two new codes, 92930 and 92945, capture complex stenting and combined-approach chronic total occlusion work.

For interventional cardiology groups and hospital cath labs, that means charge masters, coding rules and physician documentation habits built over a decade need updating. The sections below walk through what changed, how to apply the new hierarchy, and where PCI claims are most likely to lose money under the 2026 rules.

What Changed in PCI CPT Codes for 2026

The 2026 CPT update, summarized by the ACC coding corner, rewrote the PCI section in four ways:

• Branch add-ons deleted: 92921, 92925, 92929, 92934, 92938 and 92944 no longer exist. As a result, the base code for each major artery now includes its branch work.
• New 92930: stent placement in one major artery and its branches for two or more distinct lesions stented in two or more segments, or a bifurcation lesion treated in both the main artery and the side branch.
• New 92945: chronic total occlusion (CTO) revascularization using combined antegrade and retrograde approaches.
• Revised wording: base codes now read “branch(es)”, and CPT updated the lesion, segment and branch definitions. CPT also removed thrombolysis codes 92975 and 92977 from the section.

Therefore, any charge sheet, cath lab template or claim edit still listing the old branch codes will now produce rejections.

The 2026 PCI Base Codes

Each of the base PCI CPT codes now describes work in a single major coronary artery and its branches, or in one bypass graft.

The SCAI PCI coding guidelines define the major arteries as the left main, LAD, circumflex, right coronary and ramus intermedius, with up to two recognized branches each for the LAD, circumflex and RCA.

One Base Code per Vessel: Applying the Hierarchy

Coders may report only one base code for a major artery and its branches. So when the team performs several services in that vessel, report the most intensive one.

One lesion, several techniques

For example, if the physician treats a lesion with angioplasty, then atherectomy, then a stent, report 92933 once, because 92933 includes the lower services.

Two lesions in the same vessel

Two geographically separate lesions in the LAD, each stented in different segments, now report 92930. Before 2026, this extra work in one vessel had no code of its own; now 92930 captures it.

Bifurcation lesions

A bifurcation treated with angioplasty or stenting in both the main vessel and the side branch reports 92930. In contrast, treating only the main vessel reports 92928.

Separate major arteries

Work in a different major artery, such as the RCA after the LAD, gets its own base code with its own modifier.

Coronary Modifiers: LM, LD, LC, RC and RI

Every PCI base code needs a coronary modifier that names the major artery. With branch codes gone, the modifier now covers the artery and its branches:

• LM left main
• LD LAD, including its diagonal branches
• LC left circumflex, including its obtuse marginal branches
• RC right coronary artery, including the posterior descending and posterolateral branches
• RI ramus intermedius

When one intervention crosses from one artery into another, report a single code with the modifiers for both. Missing or wrong modifiers are a frequent reason payers deny the second base code as a duplicate; our guide to medical coding for cardiology covers how these modifiers fit with other cardiology claims.

Acute MI, Bypass Graft and CTO Cases

Three situations have their own base codes and rules.

Acute MI (92941)

Use 92941 for an acute total or subtotal occlusion during an acute myocardial infarction. However, PCI for a non-emergent acute coronary syndrome does not qualify. Mechanical aspiration thrombectomy (92973) can be added when performed.

Bypass grafts (92937)

Each graft counts as one major vessel, and a sequential or Y graft counts once. One graft code covers the graft, the artery it supplies and that artery’s branches. However, coders report work in the same artery through the native circulation separately.

Chronic total occlusion (92943, 92945)

Use 92943 when the wire crosses the occlusion antegrade only, and 92945 when the operator combines antegrade and retrograde approaches, with the wire crossing through collaterals from another artery. The record must show the CTO criteria, such as no antegrade flow through the true lumen.

Add-On Services in the Cath Lab

Cath labs can bill several services on top of the base PCI CPT codes when performed and documented:

• Intravascular lithotripsy (92972): add-on to any PCI base code, including 92930 and 92945.
• Mechanical aspiration thrombectomy (92973): add-on to PCI and to diagnostic catheterization codes.
• IVUS or OCT (92978, 92979): 92978 once per session for the first vessel, 92979 for each additional vessel.
• Coronary flow reserve, FFR (93571, 93572): 93571 for the first vessel, 93572 for each additional vessel.

However, all PCI codes include distal embolic protection, so it never goes on a separate line. Also, Category III codes 0913T and 0914T cover drug-coated balloons, and coders should not pair them with 92978.

Documentation Gaps That Cost PCI Payment

Under the 2026 PCI CPT codes, payment depends on details the operative note must spell out. Check each report for:

1. Every vessel and branch treated, named in a way that maps to LM, LD, LC, RC or RI.
2. The number of distinct lesions and segments stented in each vessel, which decides 92928 or 92930.
3. Bifurcation technique, showing treatment in both the main vessel and the side branch.
4. CTO approach, antegrade only or combined, with the collateral route if retrograde.
5. Acute MI status, confirming the occlusion was acute and not a non-emergent syndrome.
6. Diagnostic angiography rationale, if billed with PCI the same day: no prior study, an inadequate prior study, or a clinical change.

As a result, each missing detail can push the claim down to a lower code or into a denial. For related cath lab and cardiology coding rules, see our cardiology billing cheat sheet and cardiology coding guidelines.

Quick Scenarios

1. Two stents in the mid and distal LAD for separate lesions: 92930-LD.
2. LAD bifurcation with the first diagonal, both stented: 92930-LD.
3. Stent in the LAD and angioplasty in the RCA: 92928-LD and 92920-RC.
4. STEMI with RCA occlusion, thrombectomy and stent: 92941-RC plus 92973.

In short, each scenario uses one base code per major artery, with the modifier identifying that artery. For broader cath lab workflow and hybrid care billing, our post on interventional cardiology billing adds context.

Is Your Cath Lab Ready for the 2026 PCI Codes?

The 2026 PCI changes reward specific documentation more than ever. Branch work no longer earns its own code, so value now comes from correctly identifying complex stenting, bifurcations, combined-approach CTO work and the add-ons that go with them. Cath labs that update their templates and charge sheets now avoid months of rejected claims and quietly undercoded cases.

Interventional cardiology groups and hospital cath labs still adjusting to the new code set can have MBW RCM audit recent PCI claims against the 2026 rules. That review is available through our cardiology billing services.

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