Medtronic Plc. · NYSE:MDT
Medtronic — PowerPoint quick reference guide
43 slides from Medtronic's investor presentation, January 2026
Slide 1: Cardiac catheter ablation and electrophysiology procedures reimbursement guide
Overview 2026 Updates Coverage Reimbursement guide Cardiac catheter ablation and Coding electrophysiology procedures Payment FAQ & Resources Coding, coverage, and payment information for hospitals, References ambulatory surgery centers (ASC), and physicians Disclaimer January 2026
Slide 2: Reimbursement guide overview
Cardiac catheter ablation and electrophysiology procedures reimbursement guide Overview Cardiac catheter ablation and electrophysiology procedures 2026 Updates This guide has been developed to help you understand coverage, coding, and Medicare payment for cardiac catheter ablation and electrophysiol
Slide 3: Table of contents
Table of contents Overview 2 Overview 2026 Update 4 Coverage 5 2026 Updates Traditional Medicare coverage 5 Medicare Advantage coverage 5 Non-Medicare payer coverage 6 Coverage Best practices for documentation to substantiate coverage 6 Coding 7 CPT® codes 8 Coding HCPCS codes 19 ICD-1
Slide 4: Cardiac catheter ablations covered in ambulatory surgery center (ASC)
2026 Update Overview Cardiac catheter ablations covered in 2026 Updates ambulatory surgery center (ASC) Coverage New site of service National ASC Payment Rates Coding The Centers for Medicaid and Medicare (CMS) added cardiac catheter ablations to the ASC CPT®1 93653 93656 covered procedure list in t
Slide 5: Medicare and Medicare Advantage coverage
Coverage Medicare and Medicare Advantage Overview 2026 Updates Traditional Medicare coverage Medicare Advantage coverage Coverage Medicare has not issued a national coverage Medicare Advantage plans are required to cover at determination nor have any contractors issued a least what is covered by Tra
Slide 6: Non-Medicare payers and documentation
Coverage Non-Medicare payers and documentation Overview 2026 Updates Non-Medicare payer coverage Best practices for documentation Coverage Non-Medicare payers typically determine coverage Documentation in the patient’s medical record must for procedures based on applicable medical policies support t
Slide 7: Coding
Coding Overview The coding information below does not replace seeking coding advice from the payer and/or your own coding staff. The ultimate responsibility for correct coding lies with the provider of services. All diagnosis and procedure codes musts be supported by clear documentation within the m
Slide 8: Cardiac catheter ablation procedure CPT codes
Coding Cardiac catheter ablation procedure CPT® codes Overview CPT® codes The following CPT®1 codes describe procedures associated with cardiac catheter ablation and other electrophysiology procedures. 2026 Updates Documentation will dictate the appropriate coding. These codes may be used by physici
Slide 9: Additional cardiac catheter ablation and electrophysiology CPT codes
Coding Additional cardiac catheter ablation and electrophysiology CPT® codes Overview 2026 Updates Additional cardiac catheter ablation and Coverage electrophysiology CPT®1 codes The following add-on codes may be used in addition to an appropriate primary procedure Coding code when performed in addi
Slide 10: Additional CPT codes
Coding Additional cardiac catheter ablation CPT® codes Overview CPT® code1 Description 2026 Updates Additional cardiac catheter ablation procedures Coverage Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat dia
Slide 11: Transseptal puncture CPT codes
Coding Additional cardiac catheter ablation CPT® codes Overview 2026 Updates Transseptal puncture CPT®1 codes Coverage The following add-on code is reported when transseptal puncture is performed, however, it is included in the primary procedure code description for pulmonary vein isolation and ther
Slide 12: Intracardiac echocardiography CPT codes
Coding Additional cardiac catheter ablation CPT® codes Overview 2026 Updates Intracardiac echocardiography (ICE) CPT®1 codes Coverage Report the following when intracardiac echocardiography is performed. CPT® code1 Description Coding Intracardiac echocardiography Payment Intracardiac echocardiograph
Slide 13: 2-D mapping CPT codes
Coding Additional cardiac catheter ablation CPT® codes Overview 2026 Updates 2-D Mapping CPT®1 codes Coverage Traditional (not 3-D) mapping is considered a distinct procedure and is separately reported when performed and no 3-D mapping was performed. Coding CPT® code1 Description Mapping Payment Int
Slide 14: Comprehensive diagnostic electrophysiological studies CPT codes
Coding Additional cardiac catheter ablation CPT® codes Overview 2026 Updates Comprehensive diagnostic electrophysiological studies (EPS) CPT®1 codes Coverage Report one of the following codes when a physician performs a diagnostic EPS on a different date of service prior to a cardiac catheter ablati
Slide 15: Electrophysiology study components CPT codes
Coding Additional cardiac catheter ablation CPT® codes Overview 2026 Updates Electrophysiology study (EPS) components CPT®1 codes Coverage When a comprehensive EPS is not performed on the same date of service as the cardiac catheter ablation procedure, report additional components separately as appr
Slide 16: Add-on codes by primary ablation code
Coding Additional cardiac catheter ablation CPT® codes Overview A checkmark () indicates which add-on codes may be reported by a primary ablation code, when performed and documented. 2026 Updates 93653 93656 CPT® code1 Brief description SVT ablation PVI for AF Coverage +93609 Standard (2D mapping)
Slide 17: Moderate sedation CPT codes: same physician
Coding Moderate (conscious) sedation CPT® codes Overview Since 2017, moderate sedation is separately reportable from the cardiac catheter ablation procedure. Moderate sedation codes are time-based services. The codes are organized according to two factors: (1) whether it’s the same or a different ph
Slide 18: Moderate sedation CPT codes: different physician
Coding Moderate (conscious) sedation CPT® codes Overview 2026 Updates Different physician or qualified healthcare professional Coverage Use the following services of codes when a different physician or other qualified healthcare professional is performing the cardiac catheter ablation service and th
Slide 19: HCPCS C-codes
Coding HCPCS C-codes Overview 2026 Updates Hospital outpatient cardiac catheter ablation C-code listing Coverage Medicare provides device C-codes for hospital use in billing Medicare for medical devices in the outpatient setting5. For a complete list of Medtronic cardiac catheter ablation products a
Slide 20: ICD-10-PCS codes
Coding ICD-10-PCS codes Overview The coding information below does not replace seeking coding advice from the payer and/or your own coding staff. The ultimate responsibility for correct coding lies with the provider of services. All diagnosis and procedure codes musts 2026 Updates be supported by cl
Slide 21: ICD-10-PCS codes (continued)
Coding ICD-10-PCS codes Overview ICD-10 2026 Updates Description procedure code6 Transesophageal echocardiography (TEE) Coverage B246ZZ4 Ultrasonography of right and left heart, transesophageal Intracardiac echocardiography (ICE) Coding B246ZZ3 Ultrasonography of right and left heart, intravascular
Slide 22: ICD-10-CM diagnosis codes
Coding ICD-10-CM codes Overview The coding information below does not replace seeking coding advice from the payer and/or your own coding staff. The ultimate responsibility for correct coding lies with the provider of services. All diagnosis and procedure codes musts be supported by clear documentat
Slide 23: ICD-10-CM codes
Coding ICD-10-CM codes Overview ICD-10-CM Description 2026 Updates diagnosis code7 Cathrdiac catheter ablation procedures I48.20 Chronic atrial fibrillation, unspecified Coverage I48.3 Typical atrial flutter (type I) I48.91 Unspecified atrial fibrillation Coding I48.92 Unspecified atrial flutter I49
Slide 24: MS-DRG assignments
Coding MS-DRG assignments Overview The coding information below does not replace seeking coding advice from the payer and/or your own coding staff. The ultimate responsibility for correct coding lies with the provider of services. All diagnosis and procedure codes 2026 Updates musts be supported by
Slide 25: Payment overview
Payment Physician Overview 2026 Updates The following information reflects the Medicare national allowable amount published by CMS and does not include Medicare payment reductions resulting from sequestration adjustments to the amount payable to the provider, as mandated by the Budget Control Covera
Slide 26: Physician coding and payment
Payment Physician† Overview Physician coding and payment9,10 2026 Updates Effective January 1, 2026-December 31, 2026 Physicians use CPT® codes to represent procedures and services performed in all places of service. Coverage Under Medicare’s methodology for physician payment ,each CPT® code is assi
Slide 27: Physician payment: additional procedures
Payment Physician† Overview 2026 Medicare 2026 Updates 2026 physician 2026 CPT® code1 Description national unadjusted* work RVU10 total RVU10 physician rate9† Coverage Additional cardiac catheter ablation procedures 93655 Additional catheter ablation of discrete mechanism $261 5.36 7.81 Coding 93657
Slide 28: Physician payment: mapping and EPS
Payment Physician† Overview 2026 Medicare 2026 Updates 2026 physician 2026 CPT® code1 Description national unadjusted* work RVU10 total RVU10 physician rate9† Coverage Mapping 93609-26 Intracardiac 2D mapping of tachycardia $268 4.87 8.02 Coding Complete diagnostic electrophysiologic studies (EPS) P
Slide 29: Physician payment: EPS components and sedation
Payment Physician† Overview 2026 Medicare 2026 Updates 2026 physician 2026 CPT® code1 Description national unadjusted* work RVU10 total RVU10 physician rate9† Coverage Electrophysiology study (EPS) components 93622-26 Comprehensive EP study with LV pacing and recording $165 3.02 4.96 Coding Programm
Slide 30: Physician payment: different physician sedation
Payment Physician† Overview 2026 Medicare 2026 2026 Updates 2026 physician CPT® code1 Description national unadjusted* total Facility work RVU10 physician rate9† RVU10 Coverage Moderate (conscious) sedation – different physician 99155 Moderate sedation different physician initial 15 $82 1.90 2.44 Co
Slide 31: Ambulatory surgery center coding and payment
Payment Ambulatory surgery center (ASC) coding & payment Overview Effective January 1, 2026 - December 31, 2026 ASCs use CPT® codes for their services. Medicare payment for procedures performed in an ASC is generally based on Medicare’s ambulatory payment classification (APC) methodology for hospita
Slide 32: Hospital outpatient coding and payment (APC)
Payment Hospital outpatient coding & payment (APC) Overview Effective January 1, 2026-December 31, 2026 Hospitals use CPT® codes for outpatient services. The procedure codes below apply to services 2026 Updates performed in the hospital outpatient setting. Under Medicare’s Ambulatory Payment Classif
Slide 33: Hospital outpatient add-on codes
Payment Hospital outpatient coding & payment (APC) Overview The following add-on codes are not assigned to an APC because they are ancillary to the primary cardiac catheter ablation procedure. These codes are all classified by Medicare with a status indicator of “N” meaning that these 2026 Updates s
Slide 34: Add-on codes
Payment Add-on codes Overview Status 2026 Updates CPT® code1 Description indicator11 Mapping Coverage Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia Coding +93609 N (Use 93609 in conjuncti
Slide 35: Add-on codes (continued)
Payment Add-on codes Overview Status 2026 Updates CPT® code1 Description indicator11 Electrophysiologic studies Coverage Comprehensive EP evaluation; with left atrial pacing and recording from coronary sinus or left atrium (Use +93621 93621 in conjunction with 93620, 93653, 93654) N Coding (Do not r
Slide 36: Hospital inpatient coding and payment
Payment Hospital inpatient coding & payment Overview Hospital inpatient coding and payment12, 13 2026 Updates Effective October 1, 2025-September 30, 2026 Medicare reimbursement for inpatient hospital services is based on a classification system known as Medicare severity diagnosis related groups (M
Slide 37: New technology add-on payment (NTAP)
Payment New technology add-on payment (NTAP) Overview PulseSelectTM pulsed field ablation system NTAP overview14 NTAP is a temporary incremental payment program that provides hospitals, in limited and specific cases, with an 2026 Updates additional payment for Medicare inpatient procedures utilizing
Slide 38: Frequently asked questions
Frequently asked questions Overview 01 How is an additional ablation of a different arrhythmia reported? 2026 Updates When there is another separately identifiable arrhythmia ablated that is different from the initial arrhythmia ablation that would be reported with 93655.15 Coverage 02 How many time
Slide 39: Frequently asked questions (continued)
Frequently asked questions Overview 05 How would an additional ablation done to treat atrial fibrillation remaining after PVI be reported 2026 Updates This would be reported with the add-on code 93657 which can only be reported with 93656.15 Coverage 06 When is 2D mapping billable? Coding 2D mapping
Slide 40: Resources
Resources Overview 2026 Updates Coverage For additional information Visit our website: www.medtronic.com/crhfreimbursement Coding Email us: rs.healthcareeconomics@medtronic.com Payment Call our reimbursement customer support: 1-866-877-4102 FAQ & Resources References Disclaimer 40
Slide 41: References
References 1. CPT codes and descriptions only are copyright ©2025 American Medical Association. All rights reserved. No fee schedules are included in CPT. The American Medical Association assumes no liability for data contained or not contained herein. Overview 2. ASC 2026 Final Rule CMS-1834-FC | C
Slide 42: Disclaimer
Disclaimer Medtronic provides this information for your convenience only. It does not constitute legal or Overview reimbursement advice or a recommendation regarding clinical practice. Information provided is gathered from third-party sources and is subject to change without notice due to frequently
Slide 43: PulseSelect PFA System brief statement
PulseSelect Pulsed Field Ablation (PFA) System Brief Statement (US) Indications (or Intended Use) intracardiac echo catheters. Failure to do so may increase the risk of entrapment of the array or damage to the array, which may affect retrieval of the device into thetransseptal sheath. The PulseSelec