If your charge master or claim scrubber still pairs CPT 92924 with CPT 92925, your 2026 atherectomy claims are at risk. The AMA deleted 92925 and the other PCI branch add-on codes effective January 1, 2026. It also revised 92924 so the base code covers a major coronary artery and its branches. This guide explains how the code works today: when to report it, how modifiers and add-on services apply, what documentation supports payment, and how to judge Medicare and commercial reimbursement.

What Is CPT 92924?

CPT 92924 reports percutaneous transluminal coronary atherectomy in a single major native coronary artery and/or its branches, with balloon angioplasty included when performed. Since January 1, 2026, it also covers branch treatment that add-on code 92925 once reported.

Atherectomy removes or modifies plaque so the vessel can be dilated or stented. It is most often used in heavily calcified or fibrotic lesions that a balloon may not cross or expand. Devices include rotational, orbital, laser, and directional systems. The code is not device-specific, but the record should name the device and explain why it was needed.

92924 CPT Code Description

The 92924 CPT code description carries three coding concepts:

• Atherectomy was actually performed. If the device was never delivered, 92924 is not supported.
• Angioplasty is included. Balloon dilation is not reported separately.
• Reporting is by major artery. These are the left main, LAD, left circumflex, right coronary, and ramus intermedius. Up to two branches are recognized for the LAD, circumflex, and RCA. The left main and ramus have none.

The AMA owns the descriptor text. Use the licensed CPT code set for exact wording.

What Is CPT 92924 Coronary Atherectomy?

CPT 92924 coronary atherectomy differs from balloon angioplasty (92920) and from stenting (92928, 92930). If atherectomy and a stent are placed in the same lesion, the combined code 92933 applies. Reporting 92924 plus a stent code for one lesion double-counts the atherectomy, and it is one of the most common unbundling errors in coronary claims.

When to Report CPT 92924

When to report CPT 92924: when atherectomy was performed in a native coronary artery, no stent was placed in the treated lesion, and the record supports both the procedure and the indication.

• The note names the device and describes its use.
• The vessel is unambiguous, so the correct modifier can be assigned.
• One base code is reported per major artery, for the most intensive service.
• Treatment through a bypass graft goes to 92937, not 92924.
• Acute MI (92941) and chronic total occlusion (92943, 92945) have their own codes that include atherectomy.

All PCI codes already include access, crossing the lesion, closure, distal embolic protection, and imaging to document completion (per SCAI's 2026 guidance). These are never billed separately.

CPT 92924 Billing Workflow

CPT 92924 billing follows ten steps:

1. Complete, signed documentation
2. Code selection (most intensive service per artery)
3. Line-by-line diagnosis linkage
4. Modifier review
5. Claim creation (CMS-1500 professional, UB-04 facility)
6. Payer edits
7. Submission
8. Adjudication
9. Payment posting
10. Denial or underpayment follow-up

Errors cluster at steps 2 through 4 and step 6. Typical examples are a stent code billed with atherectomy, a missing artery modifier, and scrubber tables that still accept deleted codes. A pre-bill review at step 1 is cheaper than an appeal at step 10.

CPT 92924 Coding Guidelines for 2026

Longstanding principles (still apply):

• One PCI base code per major artery. Additional major arteries in the same session get the applicable base code with the correct artery modifier.
• A single lesion spanning two vessels and treated with one intervention is reported once, with modifiers identifying both arteries.
• Diagnostic angiography is separately reportable only when no prior study exists and the decision to intervene came from it, or when prior imaging was inadequate, the clinical picture changed, or a separate area needed evaluation (SCAI).

What changed in 2026:

• Deleted: 92921, 92925, 92929, 92934, 92938, 92944, plus thrombolysis codes 92975 and 92977.
• Revised: 92920 and 92924 now read "single major coronary artery and/or its branch(es)."
• New: 92930 (multiple distinct lesions or bifurcation stenting) and 92945 (CTO, combined antegrade and retrograde).

Payer-specific: MACs such as National Government Services and Wisconsin Physician Service publish PCI coverage articles. No national coverage determination exists for coronary atherectomy, so check your own MAC. Commercial payers update edits and policies on their own timelines.

CPT 92924 Modifier: When Is One Required?

Does CPT 92924 need a modifier? In practice, yes: the coronary artery modifier. SCAI's guidance says artery or branch modifiers must be used. Other CPT 92924 modifier choices depend on circumstances and must never be added just to clear an edit.

A missing artery modifier can cause a modifier-inconsistent denial. A misused distinct-service modifier can create an overpayment that must be refunded. Modifier 51 and multiple-procedure handling vary by payer, so check the fee schedule's multiple procedure indicator.

CPT 92924 Add-On Codes and Related Services

What modifiers and add-on codes are used with CPT 92924? Artery modifiers are standard. 92925 no longer exists, so CPT 92924 add-on codes now means the add-ons SCAI lists as reportable with 92924:

Not every performed service is separately reportable. Each add-on needs a distinct service and its own documentation, and NCCI and payer edits still apply.

CPT 92924 vs Related Coronary Intervention Codes

Documentation and Medical Necessity

A strong note lets a reviewer reconstruct the case without a phone call. It should show:

• Indication: symptoms, ischemia findings, and the reason to intervene
• Lesion and vessel: segment, calcification, length, severity
• Why atherectomy: why a balloon alone was not appropriate
• Device and technique
• Result and complications

Medical necessity is the most common basis for challenge. Some payers expect documented stable-disease indications and medical therapy history for elective PCI (a published Louisiana Healthcare Connections policy is one example). Link each procedure line to the diagnosis that supports it, keep the procedure note consistent with the referring notes, and confirm ICD-10-CM selections against the current code set. Your medical coding process should map each documented element to the code it supports.

CPT 92924 Denials: Why Claims Get Rejected

Structured denial management that tracks denials by payer and reason code makes recurring errors visible at the source.

CPT 92924 Medicare Reimbursement

What is the Medicare reimbursement for CPT 92924? There is no single number. CPT 92924 Medicare reimbursement depends on locality, site of service, and provider status.

Professional payment. Work, practice expense, and malpractice RVUs are each adjusted by a geographic index, then multiplied by the conversion factor. Facility and non-facility practice expense differ, and a cath-lab physician is typically paid the facility rate. For 2026, CMS finalized conversion factors of about $33.40 (non-qualifying APM) and $33.57 (qualifying APM). It also finalized a −2.5% efficiency adjustment to work RVUs for most non-time-based services. New codes were exempt. 92924 was revised, not new, so confirm its status in CMS's file.

As an illustration only, a manufacturer guide built from the CY 2026 final rule lists a national average unadjusted physician rate near $469. That excludes locality adjustment and is not what any given practice will receive.

Other factors:

• Participation status. Accurate credentialing and enrollment records protect payment.
• Cost-sharing. After the deductible, Medicare typically pays 80% of the allowed amount.
• Sequestration. A 2% reduction appears on the remittance.
• Facility payment is separate. It is paid under OPPS, ASC, or MS-DRG methods, not the fee schedule.

CY 2027 (proposed, not final): CMS proposes conversion factors of about $32.84 and $33.17, largely because the one-year 2.5% increase for 2026 expires. The efficiency adjustment continues. Confirm against the final rule.

How to Evaluate CPT 92924 Reimbursement and Underpayment

Billed charge is not the benchmark. Start with the allowed amount on the ERA or EOB, then compare it with your contracted rate or the locality-specific Medicare fee schedule. If the allowed amount matches, a lower-than-expected payment usually reflects deductible, coinsurance, sequestration, or a multiple-procedure reduction, not underpayment.

CPT 92924 reimbursement is easiest to audit through contract analysis, payment variance reports, ERA review, Medicare benchmarking, and denial and A/R trend review.

Are you being underpaid for CPT 92924? Possibly, but you cannot tell from the charge alone. The terms differ:

No review guarantees recovery, and some variances turn out to be valid.

Real-World CPT 92924 Coding Scenarios

These are illustrative, not actual claims.

Correct reporting. Rotational atherectomy and balloon dilation of a calcified mid-RCA lesion, no stent. Report 92924-RC. Balloon dilation is included. IVUS with its own report may support 92978. A diagnostic angiogram is separately reportable only if no prior study existed and it drove the decision to intervene.

Wrong code. "Orbital atherectomy and DES to proximal LAD" billed as 92924-LD plus 92928-LD. One lesion received both, so the correct code is 92933-LD.

Incorrect modifier. A diagnostic cath done ten days earlier showed the same lesion, with no new findings. Appending 59 to the repeat angiogram does not make it a distinct service. If it paid, review it as a possible overpayment.

True underpayment or not. A Medicare payment is below the estimate sheet. Check the allowed amount against the correct locality and site of service, then account for 20% coinsurance and 2% sequestration. If the allowed amount matches, update the estimate sheet. If not, escalate to the MAC.

Audit, Compliance, and Improvement Tips

• Audit documentation and codes against the procedure note, with attention to same-vessel combinations.
• Audit modifiers for support, and check for duplicate lines.
• Refresh NCCI and scrubber edits after each release, and verify payer policies annually.
• Educate operators on template gaps.
• If an overpayment is found, work with compliance counsel on correction and refund timing. Medicare has specific rules.
• Post payments with adjustment reasons, track variances by payer, and appeal when the record supports it.

None of this promises higher payment. It reduces avoidable loss.

CPT 92924 Compliance Checklist

• Procedure and device documented
• Medical necessity supported by the full chart
• Diagnosis linked line by line
• Correct CPT selected, no deleted codes
• NCCI and payer edits reviewed
• Artery modifier present, others evaluated
• Add-ons supported by separate documentation
• Payer policy checked
• Payment compared with expected allowed amount
• Denials and underpayments followed up

How Professional Cardiology Billing Services Can Help

PCI claims combine procedural coding, same-day diagnostic services, add-ons, and separate professional and facility rules. Specialized cardiology billing services teams can support pre-bill coding review, claim submission, denial management, A/R follow-up, payment posting, and underpayment analysis. Questions about your workflow can go through Contact Us.

Key Takeaways

• 92924 reports atherectomy in a native artery and/or its branches, with angioplasty included.
• 92925 and the other branch add-ons were deleted January 1, 2026.
• Use one base code per major artery with the correct artery modifier.
• Atherectomy plus a stent in one lesion is 92933.
• Add-ons need distinct services and separate documentation.
• Medicare payment is not one number. Verify locality, site, and participation.
• Compare allowed amounts to contract or fee schedule before calling a claim underpaid.

Conclusion

CPT 92924 is simple to define and easy to mishandle in 2026. Accurate reporting starts with a note that names the device and vessel, then moves through correct code selection, artery modifiers, payer-specific verification, and payment review against the right benchmark. Verify rules with the licensed CPT code set, CMS, your MAC, and each payer before billing.

FAQ

What is CPT Code 92924?

It reports coronary atherectomy in a single major native artery and/or its branches, with angioplasty included. Since 2026 it also covers branch treatment.

Does CPT 92924 need a modifier?

A coronary artery modifier (LC, LD, LM, RC, RI) is expected. Other modifiers apply only when documentation supports them.

What are the coding guidelines for CPT 92924 in 2026?

Report one base code per major artery for the most intensive service. Do not use deleted branch add-ons or bill a stent separately for the same lesion. Check NCCI, your MAC, and payer policy.

Which modifiers and add-on codes are applicable for CPT 92924?

Artery modifiers are standard, and 59 or XS only when an edit and documentation support it. SCAI lists 92972, 92973, 92978/92979, and 93571/93572 as reportable with 92924. 0914T applies only to a separate lesion.

What is the Medicare reimbursement for CPT 92924?

It varies by locality, site of service, and participation. One manufacturer guide lists a national average unadjusted physician rate near $469. Utilize the CMS search for your area.

Are you being underpaid for CPT 92924?

You cannot tell from the charge. Compare the allowed amount to your contract or fee schedule, then check adjustment codes and edits.

Is CPT 92925 still valid?

No. It was removed as of January 1, 2026.

Can 92924 be billed with a stent code for the same vessel?

Not for the same lesion. Use 92933. Separate arteries get separate base codes.

Can a diagnostic cath be billed with 92924?

Sometimes. It is allowed when no prior study exists and the angiogram drove the decision, or when prior imaging was inadequate or the clinical picture changed.

Does the atherectomy device change the code?

No, but document the device to support medical necessity.

What are the most common denials?

Deleted codes, bundling with diagnostic cath, same-vessel conflicts, missing artery modifiers, and medical necessity.