Coding updates

CPT 2027 changes: what cardiology and nurse practitioner practices need to do before January 1

The 2027 CPT code set is final and takes effect January 1, 2027. Here is what changed, what it means for cardiology groups and NP practices, and a checklist to avoid January denials.

Published · Global Tech Billing coding team

Quick answer

The AMA released CPT 2027 on September 9, 2026: 299 new codes, 74 revisions and 80 deletions, effective for dates of service on or after January 1, 2027. For cardiology, the headline change is three new codes for left ventricular assist devices with new and revised guidelines. Practices should remove deleted codes, load new ones, check payer policies and watch January remittances closely. Medicare payment for 2027 depends on the CY 2027 Physician Fee Schedule final rule.

299

New codes

74

Revised codes

80

Deleted codes

Jan 1, 2027

Effective

What changed in CPT 2027

The AMA describes 453 editorial changes in the 2027 code set. Ten of the new codes describe services that use artificial intelligence, which brings the total number of AI-related CPT codes to 43, and the AMA updated its taxonomy for AI services (Appendix S). Other areas with notable changes include maternity care, diaphragmatic hernia repair, prostate biopsy, biofeedback, radiology (including a new table for head and neck MR angiography) and unattended sleep studies.

What it means for cardiology practices

The cardiology change the AMA highlights is ventricular assist devices: three new codes involving left ventricular assist devices, with new and revised guidelines for reporting VAD services. Programs that implant or manage LVADs should review the new descriptors and guidelines in the official code set and update their charge capture before January.

For most cardiology groups, the bigger 2027 financial question is Medicare payment. In the CY 2027 proposed rule, CMS proposed a 1.68% lower conversion factor for clinicians who are not qualifying APM participants (1.19% for those who are) and a payment reduction when a separately identifiable office or outpatient E/M visit is billed on the same day as a procedure with a global period. If that is finalized, same-day E/M and procedure billing patterns, common in cardiology, will need a fresh look.

Our code-level guides cover the cardiology services billed most often, from calcium score CT (75571) to left heart catheterization (93458). We will update them as 2027 policies are finalized.

What it means for nurse practitioner practices

NP practices are affected mainly through payment and workflow rather than new codes. The proposed conversion factor cut applies to NP services billed to Medicare as it does to physicians. NPs in women's health should note the maternity care changes: the AMA replaced the global maternity care framework, and antepartum and postpartum visits are reported per encounter with E/M codes under the new structure.

See our guides on billing Medicare as a nurse practitioner and NP billing under a supervising physician.

CPT 2027 readiness checklist

  1. Buy or license the CPT 2027 code set and give coders time with the new ventricular assist device guidelines before January.
  2. Remove deleted codes from superbills, EHR pick lists, order sets and charge masters. Claims for dates of service on or after January 1, 2027 must use codes valid on that date.
  3. Add the new codes your providers will use and map each to a fee in your fee schedule.
  4. Check each major payer's 2027 policy updates. Commercial plans and Medicare Advantage plans often update edits and prior authorization lists on their own timeline.
  5. Re-train providers and NPs on any documentation the new or revised codes require.
  6. Hold or closely review January claims that use new codes, then watch the first 30-45 days of remittances for new denial patterns.
  7. Read the CY 2027 Medicare Physician Fee Schedule final rule when CMS publishes it, and update expected reimbursement in your practice management system.

Frequently asked questions

When do the CPT 2027 codes take effect?

The AMA released the CPT 2027 code set on September 9, 2026. The new, revised and deleted codes take effect for dates of service on or after January 1, 2027.

How many codes changed in CPT 2027?

The AMA reports 453 editorial changes: 299 new codes, 74 revisions and 80 deletions. Ten of the new codes describe AI-enabled services, bringing the total number of AI-related CPT codes to 43.

What changed for cardiology in CPT 2027?

The cardiology change the AMA highlights is ventricular assist devices: three new codes involving left ventricular assist devices, with new and revised reporting guidelines. Check the official CPT 2027 code set for the exact code numbers and descriptors, and review the Medicare fee schedule final rule for payment changes.

Can deleted CPT codes still be billed in January 2027?

No. Claims must use codes that are valid on the date of service, so deleted codes should not be used for services on or after January 1, 2027. Update superbills and EHR code lists before the first January claims go out.

How does the 2027 Medicare fee schedule proposal affect cardiology and NP practices?

In the CY 2027 proposed rule, CMS proposed lowering the conversion factor by 1.68% for clinicians who are not qualifying APM participants and by 1.19% for those who are, mainly because the one-year 2.5% increase for 2026 expires. CMS also proposed reducing payment when a separately identifiable office or outpatient E/M visit is billed by the same physician or practice on the same day as a procedure with a global period, which matters for procedure-heavy cardiology practices. These are proposals until CMS publishes the final rule.

Sources

CPT is a registered trademark of the American Medical Association. This article is general information; check the official code set, CMS rules and your payers' policies before billing.