2025 CPT code 92997
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Procedures - Other Therapeutic Cardiovascular Services and Procedures Cardiovascular System Feed
Percutaneous transluminal pulmonary artery balloon angioplasty of a single vessel.
Modifiers may be necessary to report the procedure accurately, depending on circumstances such as multiple procedures (modifier 51) or significant additional work (modifier 22). Consult the CPT manual for appropriate modifier usage.
Medical necessity for PTPA is typically established in patients with CTEPH who are not candidates for surgery or who have persistent pulmonary hypertension despite medical management.Documentation should support significant hemodynamic compromise and symptom burden to justify the procedure.
A cardiologist or interventional radiologist typically performs this procedure.Responsibilities include patient evaluation, pre-procedural preparation, arterial access, catheter placement and manipulation, balloon inflation, angiography interpretation, hemostasis, and post-procedure care.
In simple words: A doctor uses a thin tube with a tiny balloon on the end to open up a narrowed area in a lung artery.They insert the tube through a small incision in the neck or groin, inflate the balloon to widen the artery and improve blood flow, then remove the tube and close the incision.
This CPT code, 92997, describes percutaneous transluminal pulmonary artery balloon angioplasty (PTPA) performed on a single pulmonary artery vessel.The procedure involves accessing the pulmonary artery via the right internal jugular or femoral vein, inserting a balloon-tipped catheter guided by a wire, inflating the balloon at the stenosis site to widen the vessel lumen, and improving blood flow.Angiography with contrast dye is utilized for visualization and accurate catheter placement. Post-procedure, equipment is removed, hemostasis is achieved, and the incision(s) is/are closed.
Example 1: A 65-year-old female with chronic thromboembolic pulmonary hypertension (CTEPH) undergoes PTPA for significant stenosis in a single pulmonary artery branch.The procedure successfully improves her pulmonary artery pressure and exercise tolerance., A 72-year-old male with inoperable CTEPH is treated with PTPA.Multiple sessions are required due to extensive disease.Code 92997 is billed for each session, with add-on code 92998 appropriately added for subsequent vessels treated., A 58-year-old patient presents with severe pulmonary hypertension secondary to a large pulmonary embolus.After failing medical management, they undergo PTPA.The procedure demonstrates improvement in hemodynamics; however, additional procedures are required.
* Pre-procedure history and physical examination documenting the indication for the procedure.* Angiographic images demonstrating the stenosis and the result of the angioplasty.* Procedure report detailing the approach (right internal jugular vein or right femoral vein access), catheter placement, balloon inflation, and post-procedure findings.* Hemodynamic data (if available) demonstrating improvement in pulmonary artery pressure.* Post-procedure monitoring and recovery notes.
** This procedure is relatively complex and requires specialized expertise.The success of the procedure is influenced by various factors including the extent of the disease, the location and severity of the stenosis, and operator experience.Complications such as pulmonary edema, bleeding, and vessel injury may occur.
- Revenue Code: 0220, 0221 (verify payer-specific revenue codes)
- RVU: The RVUs for this code vary based on geographical location, facility type (hospital outpatient vs. physician office), and other factors. Consult a local fee schedule or claims processing system for current RVU values and reimbursement rates.
- Global Days: The global period for this procedure is dependent on payer-specific guidelines.It is likely to include the day of the procedure and potentially several days post-procedure for follow-up care. Consult payer guidelines for specifics.
- Payment Status: Active
- Modifier TC rule: A TC modifier is not typically applicable to this code as it represents the entire procedure.
- Fee Schedule: Historical fee schedules vary greatly based on payer, location, and year.The information cannot be found in current available data.
- Specialties:Cardiology, Interventional Cardiology, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center