On Demand: 2026 CPT Coding and MPFS Final Rule Changes: Impacts to Cardiovascular Services-Presentation Slides

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The 2026 CPT Coding and Medicare Physician Fee Schedule (MPFS) Final Rule changes significantly impact cardiovascular services. Cardiology MPFS reimbursement is projected to increase by about 1%, but facility-based cardiology services may decline 7%, while non-facility services increase 5%. Key changes include substantial revisions to codes for Left Atrial Appendage Occlusion (LAAO), Percutaneous Coronary Intervention (PCI), and Lower Extremity Revascularization (LER), the latter receiving its most significant update in a decade, with 16 codes replaced by 46 new ones defining multiple new vascular territories, lesion complexities, and procedural specifics.<br /><br />The 2026 CPT code set introduces 418 changes, including 288 new codes, 84 deletions, and 46 revisions, reflecting advances such as augmentative AI services and shorter-duration remote monitoring. Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) receive new code guidance emphasizing device use, patient interaction requirements, and billing restrictions.<br /><br />In surgical codes, thoracic aortic endovascular repair codes have been restructured to reflect different graft configurations and procedural variations, including coverage of the left subclavian artery. PCI coding deletes branch codes and revises primary and stent codes for clarity, adding new codes for chronic total occlusion (CTO) procedures. Documentation guidelines stress detailed lesion description, vascular territory specification, and interventions performed.<br /><br />Ambulatory Surgery Center (ASC) procedure listings have been updated to include new controls, with certain services reclassified or payment rates adjusted.<br /><br />Radiology coding sees a replacement of category III coronary CT angiography (CCTA) plaque quantification codes with a new PLAQ quantification code, bundled with CCTA and physiological assessments.<br /><br />Category III codes continue tracking emerging technologies like cardiac contractility modulation, wireless inferior vena cava sensors, intravascular cerebral vessel imaging, and endovascular aortic wall stabilization drug therapy.<br /><br />These comprehensive updates highlight evolving cardiovascular care complexity, emphasizing precise coding, detailed documentation, and alignment with new technological and procedural advances to optimize reimbursement and compliance.

Keywords

2026 CPT Coding

Medicare Physician Fee Schedule

Cardiology reimbursement

Left Atrial Appendage Occlusion

Percutaneous Coronary Intervention

Lower Extremity Revascularization

Remote Physiologic Monitoring

Thoracic aortic endovascular repair

Ambulatory Surgery Center updates

Cardiac imaging technologies