The Medicare Payment Advisory Commission (MedPAC) issued its annual June series of reports to Congress on Medicare spending, and the data report takes aim at purportedly low-value items and services, including percutaneous intervention in patients with stable coronary artery disease (CAD). The controversy is not new, but the appearance of that consideration in the MedPAC report seems certain to apply more pressure on the combination of angioplasty and stenting, a mainstay of the cardiology devices sector.