Summary & Overview
CPT 92987: Percutaneous Mitral Valvuloplasty (Balloon Dilation)
CPT code 92987 represents percutaneous balloon mitral valvuloplasty, a catheter-based procedure to open a stenotic mitral valve and improve blood flow. This structural heart intervention is clinically important for patients with symptomatic mitral stenosis who are candidates for a less invasive alternative to surgical valve repair or replacement. Nationally, the code is relevant for hospitals, cardiac centers, and payers managing complex cardiac procedural episodes and post-procedure care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, and the procedural description tied to CPT code 92987. The publication also outlines common billing considerations, lists frequently used modifiers provided in the input, and summarizes where data is available or missing.
The report provides practical benchmarks and policy-relevant points for coding and coverage discussions, clinical settings where the procedure is performed, and payer coverage patterns when available. Data not available in the input (such as associated taxonomies, ICD-10 diagnosis mappings, related codes, and service-line cost benchmarks) are noted as missing elsewhere in the publication rather than here. This national-level summary is intended to inform billing teams, clinical coders, and policy analysts about the clinical meaning and administrative context of CPT code 92987.
Billing Code Overview
CPT code 92987 describes a percutaneous transcatheter procedure in which a provider opens a stenotic mitral valve using a balloon catheter to improve mitral valve opening and restore blood flow. This is a valvuloplasty of the mitral valve performed via catheter-based balloon dilation.
Service Type: Interventional cardiology / structural heart procedure
Typical Site of Service: Cardiac catheterization laboratory or hybrid operating room, with patients commonly admitted from an inpatient setting or treated in an ambulatory surgical center depending on clinical status.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 55–75-year-old individual presenting with symptomatic mitral stenosis characterized by exertional dyspnea, fatigue, orthopnea, or recurrent pulmonary edema. Physical exam often reveals a diastolic murmur with loud S1 and findings of pulmonary congestion. Transthoracic and transesophageal echocardiography confirm a stenotic mitral valve with pliable leaflets, commissural fusion, and an appropriate Wilkins score supporting percutaneous mitral balloon commissurotomy. The clinical workflow includes pre-procedure evaluation (history, ECG, echocardiography, anticoagulation review), informed consent, vascular access (usually femoral venous), transseptal puncture, balloon commissurotomy under fluoroscopic and echocardiographic guidance, immediate post-procedure echocardiography to assess valve area and regurgitation, monitoring for complications (cardiac tamponade, severe mitral regurgitation, vascular access bleeding), and post-procedure discharge planning with follow-up echocardiography and anticoagulation management as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default reporting | Use when no additional modifier applies; report alone with the procedure code |
52 |