Cardiology CPT Code Cheat Sheet: Complete Billing Reference for Cardiologists

Cardiology CPT Code Cheat Sheet: Complete Billing Reference for Cardiologists

Cardiology is one of the most code-intensive specialties in medicine. In a single visit, the patient may get an ECG, and a stress echo. Both have their own CPT code, and documentation requirements.

This cardiology CPT code cheat sheet makes billing easier for you. It organizes the most commonly used cardiovascular procedure codes by clinical category. This helps you quickly identify the appropriate code, and avoid common coding errors.

What CPT Code Range Covers Cardiology Services?

Cardiology CPT codes primarily fall within the AMA range 92920–93799. It includes:

  • Diagnostic
  • Interventional
  • Electrophysiology 
  • Device management services.

 Evaluation and Management codes (99202–99215) apply separately for office visits.

The AMA defines cardiovascular services across two main CPT ranges. 

  1. Noninvasive services: Use codes in the 93000s. 
  • ECG
  • Echocardiogram
  • Stress test
  • Holter, 
  1. Interventional procedures: Use codes beginning with 92920. 
  • Angioplasty
  • Stent placement
  • Cardiac catheterization 

What Are the CPT Codes for ECG and Electrocardiography?

For ECG services,  use 93000–93042. A complete ECG with interpretation and report will be coded 93000. The interpretation and report only code is 93010, if the technical component is charged separately.

 

ECG CPT CODES
CPT Code Description Key Billing Note
93000 Routine ECG, 12+ leads, with interpretation and report Global code: technical + professional combined
93005 ECG tracing only (no interpretation) Technical component only, facility bills this
93010 ECG interpretation and report only Professional component, physician bills when not performing tracing
93040 Rhythm ECG, 1–3 leads with interpretation Used for arrhythmia monitoring, shorter study
93041 Rhythm ECG, 1–3 leads, tracing only Technical component of rhythm ECG
93042 Rhythm ECG, 1–3 leads, interpretation only Professional component of rhythm ECG

 

What Are the CPT Codes for Echocardiography?

For echocardiography, use 93303-93352. 

 

ECHOCARDIOGRAPHY CPT CODES
CPT Code Description Key Billing Note
93303 Transthoracic echo, congenital anomalies, complete Used for pediatric/congenital heart disease
93304 Transthoracic echo, congenital anomalies, limited/follow-up Follow-up or limited congenital study
93306 Complete TTE with spectral and color flow Doppler Most common adult echo code, global service
93307 TTE without Doppler flow analysis Use when Doppler is not performed
93308 TTE, follow-up or limited study Focused or repeat echo, not complete study
93312 TEE, probe placement and imaging Transesophageal echo global code
93315 TEE, for congenital cardiac anomalies Specific to congenital disease evaluation
93318 TEE, monitoring purposes only Intraoperative monitoring; no diagnostic interpretation
93350 Stress echocardiography, complete Exercise or pharmacologic stress with echo imaging
93351 Stress echocardiography, with contrast Add contrast when endocardial border visualization inadequate

 

The standard adult echo is code 93306. When M-mode or 2D imaging are used, but Doppler is not used, use 93307. Bill 93306 and 93308 for the same encounter, 93308 is a limited study.

The stress test is part of the stress echo codes 93350 and 93351. Do not additionally bill 93015, when stress echo is performed.

What Are the CPT Codes for Cardiac Stress Testing?

For stress testing, use 93015–93018. The complete stress test is Code 93015. Use When different providers provide different parts of the service, use:

  • 93016
  • 93017 
  • 93018 

 

CARDIAC STRESS TEST CPT CODES
CPT Code Description Key Billing Note
93015 Complete cardiovascular stress test, supervision, tracing, interpretation, and report Global code, use when one provider does everything
93016 Supervision only (physician present, no tracing/report) Component, physician supervises but tech performs tracing
93017 Tracing only (no supervision or report) Technical component, facility or tech bills this
93018 Interpretation and report only Professional component, physician reviews and reports only

 

If the physician only reads and reports the tracing, use 93018. That would be an upcoding, which is an audit flag that would be billed as 93015.

Nuclear stress tests have different codes: 78451 (SPECT – single study) and 78452 (SPECT – multiple studies, at rest and stress). These are codes for nuclear medicine procedures, not codes for cardiovascular stress test procedures and should be billed separately.

 

What Are the CPT Codes for Holter and Cardiac Monitoring?

The Holter monitor procedure is the use of CPT codes 93224–93229. The complete 24-hour monitoring is covered under code 93224 including recording, scanning, interpretation and report. With code 93228, mobile cardiac telemetry up to 30 days is provided.

 

HOLTER AND AMBULATORY MONITORING CPT CODES
CPT Code Description Key Billing Note
93224 Holter monitoring, up to 48 hours, complete (hookup, recording, scanning, interpretation) Global code for complete 24–48 hour Holter service
93225 Recording only (hookup and recording) Technical component, patient-worn recorder applied
93226 Scanning analysis with report Computer analysis of rhythm strips
93227 Physician review and interpretation Professional component only
93228 Mobile cardiac telemetry, up to 30 days, recording, analysis, and report Real-time transmission monitoring
93229 Technical support for mobile cardiac telemetry Technical component only for 93228 service

 

These should not be coded separately as 93224 and 93227 for the same monitoring period. This code is global and has all components. Component splitting is only appropriate if there is a real distinction in the responsibilities of the various entities in performing and billing the various components.

What Are the CPT Codes for Cardiac Catheterization?

For cardiac catheterization, use 93451 – 93464. Right heart catheterization is performed with the use of 93451. 93452 is used for left heart catheterization. When combined right and left, it totals 93453. Vessel specific imaging is also provided by the codes for coronary angiography (93454-93461).

 

CARDIAC CATHETERIZATION CPT CODES
CPT Code Description Key Billing Note
93451 Right heart catheterization (RHC) Includes hemodynamic measurements
93452 Left heart catheterization (LHC) Includes ventriculography when performed
93453 Combined right and left heart Single code, do not bill 93451 + 93452 together
93454 Coronary angiography without LHC Diagnostic imaging only; no catheterization component
93455 Coronary angiography + bypass graft imaging, without LHC Includes bypass graft evaluation
93456 Coronary angiography with right heart cath Includes hemodynamic RHC measurements
93457 Coronary angiography + bypass graft imaging + RHC Comprehensive right-side + coronary imaging
93458 LHC + coronary angiography Most common cath lab combination code
93459 LHC + coronary angiography + bypass graft imaging Adds graft visualization to 93458
93460 RHC + LHC + coronary angiography Full combined study without bypass grafts
93461 RHC + LHC + coronary angiography + bypass graft imaging Most comprehensive single cath code
93462 Left heart catheterization by transseptal puncture Add-on to primary cath code, not standalone
93463 Pharmacologic agent injection during cath Add-on code for vasodilator/provocative testing
93464 Physiologic exercise study during cath Add-on for exercise hemodynamics during procedure

 

Do not bill 93451 + 93452 for right and left heart catheterization. Use 93453. Billing them separately will be an NCCI bundle violation.

What Are the CPT Codes for Interventional Cardiology (PCI)?

The PVI codes begin with 92920. Code 92928 is for the placement of a stent, with or without angioplasty of the major coronary artery or branch. There is an add-on code for branch vessel stenting of 92929.

 

INTERVENTIONAL CARDIOLOGY (PCI) CPT CODES
CPT Code Description Key Billing Note
92920 PTCA, single major vessel Balloon dilation only; no stent placement
92921 PTCA – additional branch (add-on) Add-on to 92920 for each additional branch treated
92928 PCI with stent placement, single major vessel Covers stent with or without angioplasty
92929 PCI with stent, additional branch (add-on) Add-on per additional branch stented
92933 PCI with atherectomy, single major vessel Atherectomy with or without angioplasty/stent
92934 PCI with atherectomy, additional branch (add-on) Add-on per additional branch
92937 PCI in native coronary artery for acute MI Primary PCI, STEMI intervention code
92941 PCI in native artery for acute MI, additional vessel (add-on) Multivessel STEMI intervention
92943 PCI in chronic total occlusion (CTO) CTO-specific intervention code
92944 PCI in CTO – additional vessel (add-on) Add-on for each additional CTO treated

 

 What Are the CPT Codes for Electrophysiology Studies?

Use 93600–93660 for electrophysiology studies. 

 

ELECTROPHYSIOLOGY (EP) CPT CODES
CPT Code Description Key Billing Note
93600 Bundle of His recording only Standalone His bundle recording, rarely billed alone
93602 Intra-atrial recording Atrial electrogram recording
93603 Right ventricular stimulation and pacing RV pacing study component
93619 Comprehensive EP study, no induction of arrhythmia Includes His bundle + atrial + RV recording and pacing
93620 Comprehensive EP study, with induction attempt Adds arrhythmia induction protocol to 93619
93621 Left atrial pacing and recording, add-on Add-on to 93619 or 93620 when LA access obtained
93622 Left ventricular pacing and recording, add-on Add-on for LV stimulation component
93623 Programmed stimulation after drug infusion, add-on Repeat EP testing after antiarrhythmic drug administration
93640 EP evaluation of single or dual chamber pacing cardioverter-defibrillator ICD testing, threshold determination
93641 EP evaluation of ICD + device testing (add-on) Comprehensive ICD programming with testing
93650 AV node ablation Catheter ablation to achieve complete heart block
93653 EP study + ablation for supraventricular tachycardia (SVT) Includes comprehensive EP study + ablation
93654 EP study + ablation for ventricular tachycardia (VT) Includes mapping and ablation of VT
93655 Ablation of additional arrhythmia at same session (add-on) Add-on for each additional arrhythmia mechanism ablated
93656 Catheter ablation for atrial fibrillation, pulmonary vein isolation (PVI) Primary AFib ablation code, includes EP study
93657 Additional linear or focal ablation for AFib (add-on) Add-on for extra lesion sets beyond PVI

 

What Are the CPT Codes for Pacemakers and ICDs?

Pacemaker and/or ICD codes are 33202-33249. 

 

PACEMAKER AND ICD IMPLANT CPT CODES
CPT Code Description
33206 Insert/replace pacemaker, atrial electrode only
33207 Insert/replace pacemaker, ventricular electrode only
33208 Insert/replace dual-chamber pacemaker (atrial + ventricular electrodes)
33212 Insert pacemaker pulse generator, single-chamber, existing lead(s)
33213 Insert dual-chamber pulse generator, existing leads
33214 Upgrade single-chamber to dual-chamber pacemaker system
33221 Insert dual-chamber pacemaker pulse generator, multiple existing leads
33224 Insert electrode for cardiac resynchronization therapy (LV lead)
33225 Insert LV electrode for CRT, add-on to ICD implant
33240 Insert ICD, single chamber
33249 Insert ICD, dual chamber
33270 Insert subcutaneous ICD (SICD)
33274 Transcatheter implant of leadless pacemaker, RV
33275 Transcatheter removal of leadless pacemaker, RV

 

REMOTE MONITORING AND DEVICE PROGRAMMING CPT CODES
CPT Code Description
93279 Programming pacemaker, single-chamber, in-person
93280 Programming pacemaker, dual-chamber, in-person
93281 Programming pacemaker, multiple lead system (CRT-P), in-person
93288 Interrogation pacemaker, single-chamber, in-person (no programming)
93289 Interrogation pacemaker, dual-chamber, in-person
93291 Remote interrogation pacemaker, single-chamber, 30 days
93293 Remote interrogation pacemaker, single-chamber, 90 days
93294 Remote interrogation pacemaker, dual/multi chamber, 90 days
93295 Remote interrogation ICD, dual/multi chamber, 90 days
93296 Remote technical support for device monitoring, 90 days (technical component)
93297 Remote monitoring pacemaker, CRT-P, 30-day data transmission
93298 Remote monitoring ICD, CRT-D, 30-day transmission

 

 What Cardiology Modifiers Are Most Commonly Used?

Modifiers for cardiology services include:

  • 26 – professional component
  • TC – technical component
  • 59 – distinct procedural service 
  • 25 – separate E/M on the same day as procedure), and LT/RT

 

CARDIOLOGY BILLING MODIFIERS
Modifier When to Use in Cardiology
26 – Professional Component Physician billed interpretation of echo or nuclear study performed by facility
TC – Technical Component Facility bills for equipment and technician; no physician interpretation
59 – Distinct Procedural Service Separately reportable procedure not normally billed same day, must document distinctness
25 – Separate E/M Service Significant E/M performed same day as cardiology procedure; requires separate documentation
LT / RT- Left/Right Side-specific for bilateral cardiac procedures, required when anatomic laterality matters
32 – Mandated Service Service ordered by third-party payer or government agency, rare but applicable
52 – Reduced Services Procedure partially performed; documentation must explain what was not completed
76 – Repeat Procedure Same procedure repeated by same physician, not a duplicate billing flag

 

 What Are the CPT Codes for Cardiac Rehabilitation?

Use 93797 and 93798 for cardiac rehab.

  1. 93797: One 30 minute supervised session, not monitored by ECG
  2. 93798: A 30-minute session of ECG monitoring.

 

CARDIAC REHABILITATION CPT CODES
CPT Code Description
93797 Cardiac rehab, 30-minute session without ECG monitoring
93798 Cardiac rehab, 30-minute session with ECG monitoring
G0422 Intensive cardiac rehab with exercise, 1 hour (Medicare)
G0423 Intensive cardiac rehab with exercise, 1 hour (additional sessions)

 

Need Cardiology Billing Support?

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Contact us today to learn how our cardiology billing services can help your practice improve cash flow.

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