CPT 92997 Pulmonary Artery Balloon Angioplasty Reimbursement | OpenPayer

Summary & Overview

CPT 92997: Pulmonary Artery Balloon Angioplasty, Single Vessel

CPT code 92997 represents percutaneous transluminal balloon angioplasty of a single pulmonary artery vessel to relieve stenosis. This interventional cardiology procedure is performed to restore pulmonary arterial blood flow and can be critical in managing pulmonary vascular obstruction and select congenital or acquired pulmonary artery lesions. Nationally, the code is relevant for hospitals and interventional specialists who perform catheter-based pulmonary vascular interventions.

Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which major payers commonly process claims for this service. The publication outlines billing considerations, common modifiers, and related service-line implications where available. It also highlights benchmarking and policy themes relevant to reimbursement and coverage for pulmonary artery balloon angioplasty. Practical details address documentation focus and procedure-level definitions to help billing, coding, and clinical teams align on claims submission and classification.

Data not available in the input: specific payor coverage policies, associated taxonomies, ICD-10 diagnoses, related CPT or ancillary codes, and service-line volume benchmarks.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare92997CPTpulmonary-artery-angioplastyballoon-angioplastyinterventional-cardiologycatheterization-labpulmonary-stenosisvascular-procedure

Billing Code Overview

CPT code 92997 describes percutaneous transluminal balloon angioplasty of a single pulmonary artery vessel to treat focal stenosis. The procedure involves inflating a balloon-tipped catheter within the narrowed segment of a pulmonary artery to restore or improve blood flow.

Service type: Percutaneous pulmonary artery balloon angioplasty
Typical site of service: Hospital catheterization laboratory or interventional cardiology/vascular suite

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with symptomatic pulmonary artery stenosis or thromboembolic disease causing localized obstruction and right ventricular strain. The patient may present with progressive exertional dyspnea, hypoxemia, chest discomfort, or signs of right heart failure. Diagnostic workup includes chest CT angiography or ventilation-perfusion scan and right heart catheterization confirming a focal lesion in a single pulmonary artery branch amenable to balloon angioplasty. The interventional cardiology or interventional radiology team performs the procedure in a cardiac catheterization laboratory or interventional suite under fluoroscopic guidance. The workflow includes pre-procedure informed consent, vascular access (typically femoral or jugular), selective pulmonary angiography to identify the target vessel, advancement of a balloon-tipped catheter to the stenotic segment, controlled inflation to dilate the lesion, post-dilation angiography to document result, hemostasis of the access site, and post-procedure monitoring for reperfusion injury or access complications. Typical personnel include the attending interventionalist, scrub nurse, radiologic technologist, and recovery nursing staff. Usual site of service is an outpatient interventional suite or inpatient catheterization lab depending on patient stability and comorbidities.

Coding Specifications

Modifier	Description	When to Use
`59`	Distinct procedural service	Use when a separate, distinct procedure not normally billed together is performed on a different site or vessel during the same session, if documentation supports distinctness from .

CPT 92973: Percutaneous Coronary Mechanical Thrombectomy (Aspiration)

CPT-92961-ELECTRICAL-CARDIOVERSION-WITH-IV-MEDICATION

CPT 92961: Electrical Cardioversion with Intravenous Antiarrhythmic Medication

92960-CARDIOVERSION-ELECTIVE-ELECTRICAL-CONVERSION-OF-ARRHYTHMIA

CPT 92960: Elective External Cardioversion for Cardiac Arrhythmias

92950-CARDIOPULMONARY-RESUSCITATION-EG-IN-CARDIAC

CPT 92950: Cardiopulmonary Resuscitation in Cardiac Arrest

CPT-92986-BALLOON-AORTIC-VALVULOPLASTY

CPT 92986: Balloon Aortic Valvuloplasty, Percutaneous

CPT-92953-CARDIAC-ELECTRICAL-STIMULATION-FOR-ARRHYTHMIA

CPT 92953: Cardiac Electrical Stimulation for Arrhythmia

CPT-92974-INTRAVASCULAR-BRACHYTHERAPY-FOR-CORONARY-STENOSIS

CPT 92974: Coronary Brachytherapy Adjunct to Stenosis Treatment

CPT-92970-AORTIC-BALLOON-CATHETER-CIRCULATORY-ASSIST

CPT 92970: Aortic Balloon-Tipped Catheter for Circulatory Assist

CPT-92998-PULMONARY-ARTERY-BALLOON-ANGIOPLASTY-ADDITIONAL-VESSEL

CPT 92998: Pulmonary Artery Balloon Angioplasty, Additional Vessel

CPT-92971-LOWER-EXTREMITY-PNEUMATIC-COMPRESSION

CPT 92971: Lower Extremity Intermittent Pneumatic Compression

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92997

Taxonomy Code	Specialty	Notes
207RP1001X	Interventional Cardiology	Common specialty performing pulmonary artery balloon angioplasty in adults.
2086S0203X	Interventional Radiology	Frequently performs endovascular pulmonary interventions and angioplasty.
207RI0002X	Pediatric Cardiology	Performs pulmonary artery angioplasty in pediatric patients with congenital pulmonary artery stenosis.
207RN0401X	Cardiothoracic Surgery	May be involved for hybrid or surgical-adjacent cases or complications.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93458`	Catheter placement in coronary or pulmonary artery with imaging, including transcatheter therapy when performed	Often used for comprehensive right and left heart catheterization with pulmonary angiography performed before balloon angioplasty; may be billed when diagnostic catheterization with imaging is performed in same session.
`93505`	Right heart catheterization including measurement(s) of oxygen saturation and cardiac output when performed; with diagnostic selective pulmonary angiography	Commonly performed immediately prior to `92997` to map pulmonary arterial anatomy and hemodynamics.
`92980`	Percutaneous transcatheter implantation of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch (for reference)	Not specific to pulmonary arteries but listed as a related endovascular angioplasty/stent family; stenting codes may be considered if stent placement in pulmonary artery is performed (use appropriate pulmonary stent codes when available).
`36475`	Endovascular repair arterial (e.g., angioplasty) — (example peripheral)	Represents peripheral angioplasty procedures; included as related endovascular technique analog though not pulmonary-specific.
`99024`	Postoperative follow-up visit global period, related to surgical procedure	May apply for reporting focused postoperative follow-up in global period if payer requires separate reporting for specific services.

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