Summary & Overview
CPT 92941: Percutaneous Coronary Revascularization During Acute Myocardial Infarction
CPT code 92941 is a critical billing code for percutaneous coronary intervention performed during an acute myocardial infarction, specifically addressing acute total or subtotal occlusions in a single coronary vessel. This procedure is essential in emergency cardiovascular care, often involving stent placement, atherectomy, angioplasty, and aspiration thrombectomy. The code is widely recognized across major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, ensuring broad coverage for patients requiring urgent revascularization.
This publication provides a comprehensive overview of 92941, including its clinical context, typical hospital outpatient settings, and its role in acute cardiac care. Readers will gain insights into payer coverage, relevant policy updates, and benchmarks for this high-impact cardiovascular procedure. The summary also highlights associated modifiers, taxonomies, and related CPT codes, offering a clear understanding of how 92941 fits within the broader landscape of interventional cardiology billing and coding. The information is designed to support healthcare professionals, administrators, and policy analysts in navigating the complexities of coding and reimbursement for acute myocardial infarction interventions.
CPT Code Overview
CPT code 92941 represents a percutaneous transluminal revascularization procedure performed during an acute myocardial infarction. This intervention targets acute total or subtotal occlusions in a coronary artery or coronary artery bypass graft. The procedure may involve any combination of intracoronary stent placement, atherectomy, angioplasty, and aspiration thrombectomy when performed, and is coded for a single vessel.
Service Type: Cardiovascular – Percutaneous Coronary Intervention
Typical Site of Service: Hospital Outpatient settings, such as outpatient catheterization laboratories (POS 22).
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to the hospital outpatient setting, such as an outpatient catheterization laboratory, with symptoms of an acute myocardial infarction (heart attack). The patient is diagnosed with a ST elevation myocardial infarction (STEMI) involving a specific coronary artery. The interventional cardiology team performs a percutaneous transluminal revascularization to treat an acute total or subtotal occlusion in a single coronary vessel. The procedure may include intracoronary stent placement, atherectomy, angioplasty, and aspiration thrombectomy if needed. The goal is to restore blood flow and minimize heart muscle damage during the acute event.
Coding Specifications
Common Modifiers:
| Modifier Code | Description | When to Use |
|---|---|---|
LD | Left Anterior Descending coronary artery | Procedure performed on the left anterior descending artery |
LC | Left Circumflex coronary artery | Procedure performed on the left circumflex artery |
RC | Right Coronary artery | Procedure performed on the right coronary artery |
LM | Left Main coronary artery | Procedure performed on the left main coronary artery |
RI | Ramus Intermedius coronary artery | Procedure performed on the ramus intermedius artery |
Associated Provider Taxonomies:
207RC0000X– Cardiovascular Disease Physician (specializes in cardiovascular diseases)207RI0011X– Interventional Cardiology Physician (specializes in interventional cardiology procedures)207RG0300X– Geriatric Medicine Physician (specializes in care of older adults, may be involved in complex cases)
Related Diagnoses
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I21.01– ST elevation (STEMI) myocardial infarction involving left main coronary artery- Indicates an acute heart attack affecting the left main coronary artery, relevant for revascularization of this vessel.
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I21.02– ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery- Represents an acute heart attack in the left anterior descending artery, commonly treated with percutaneous intervention.
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I21.09– ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall- Refers to STEMI affecting other arteries of the anterior wall, which may require revascularization.
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I21.11– ST elevation (STEMI) myocardial infarction involving right coronary artery- Indicates STEMI in the right coronary artery, a frequent target for percutaneous intervention.
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I21.19– ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall- Refers to STEMI in other arteries of the inferior wall, relevant for acute revascularization procedures.
Clinical Relevance:
- All listed ICD-10 codes represent acute STEMI events in specific coronary arteries, directly related to the use of CPT code
92941for percutaneous revascularization during an acute myocardial infarction.
Related CPT Codes
| CPT Code | Description | Clinical Relationship |
|---|---|---|
92937 | Percutaneous transluminal revascularization of or through coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel | Used for revascularization through a bypass graft, single vessel; alternative to 92941 when graft is involved |
92938 | Percutaneous transluminal revascularization of or through coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (List separately in addition to code for primary procedure) | Used in addition to 92937 for each additional branch treated during the same session |
92943 | Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel | Used for chronic (not acute) total occlusions; alternative to 92941 for chronic cases |
92944 | Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (List separately in addition to code for primary procedure) | Used in addition to 92943 for each additional vessel treated in chronic occlusion cases |
Summary:
92937and92938are used for procedures involving bypass grafts.92943and92944are used for chronic occlusions, not acute events.- These codes may be used as alternatives or in addition to
92941depending on the clinical scenario.
National Reimbursement Benchmarks
Nationally, Medicare's mean rate for CPT code 92941 is $590.39, which is significantly lower than the BUCA (Blue Cross Blue Shield, UnitedHealth Group, Cigna, and Aetna) commercial average of $954.31. Commercial payers consistently reimburse at higher levels compared to Medicare, with UnitedHealth Group and Cigna offering the highest mean rates among the major payers.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies across payers. Medicare exhibits the tightest range ($46.00), indicating relatively consistent reimbursement. In contrast, UnitedHealth Group shows the widest spread ($650.00), followed by Cigna ($592.90), reflecting greater variability in commercial rates. The table and chart below present the full breakdown of national benchmarks for each payer.
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