CPT 92920 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Cardiovascular Procedures |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LD - Left anterior descending coronary artery • LC - Left circumflex coronary artery |
| Complexity Level | Moderate |
National average reimbursement for CPT 92920 by major payers:
$747.10
$737.21
$707.16
$864.99
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 92920 | ||||||
United | 92920 | $6044.00 | 1437574191 - | 464090110 - (LA) OIL CENTER SURGICAL PLAZA | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 92920 | $751.53 | 1932123247 - DALLAS COUNTY HOSPITAL DISTRICT, PARKLAND HEALTH | 756004221 - DALLAS COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $10390.00 | 1134166192 - ORTHOPEDIC HOSPITAL LTD, TEXAS ORTHOPEDIC HOSPITAL | 760418502 - (TX) ORTHOPEDIC HOSPITAL LTD | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $1401.00 | 1710932470 - HOSPITAL SERVICE DISTRICT NO1 PARISH OF AVOYELLES STATE OF LOUISIANA | 720697593 | LA | Critical Access Hospital (282NC0060X) |
United | 92920 | $8645.95 | 1396520862 - LAKE SURGICAL HOSPITAL SLIDELL, LLC | 474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 92920 | $18756.00 | 1659352987 - USMD HOSPITAL AT ARLINGTON, L.P. | 731662763 - (TX) USMD HOSPITAL AT ARLINGTON, LP | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $2700.00 | 1235706888 - SOUTHERN SURGICAL CENTER, LLC | 844035828 - (LA) SOUTHERN SURGICAL CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 92920 | $32381.00 | 1083937593 - METHODIST HEALTH CENTERS, HOUSTON METHODIST WEST HOSPITAL | 760545192 - METHODIST HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $13032.00 | 1972517365 - COVENANT MEDICAL CENTER | 822913146 - (TX) COVENANT MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $20444.00 | 1295843753 - VALLEY BAPTIST MEDICAL CENTER | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $41592.00 | 1598766495 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER,INC | 720423635 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | 92920 | $12063.00 | 1245878990 - HUNTSVILLE COMMUNITY HOSPITAL, INC. | 843654542 - (TX) HUNTSVILLE COMMUNITY HOSPITAL INC | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $22245.00 | 1205382413 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL ZARZAMORA | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $39845.00 | 1457994188 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MICRO-HOSPITAL WESLACO | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $23321.00 | 1598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 92920 vs. Other Cardiovascular Procedures Codes
The CPT 92920 code is part of the Medicine Services and Procedures services used for Cardiovascular Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 92920 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 92920-CPT | Moderate | Balloon Dilation Of Narrowed Or Blocked Major Coronary Artery Or Branch (Accessed Through The Skin), |
| 92921-CPT | Moderate | Percutaneous Transluminal Coronary Angioplasty; Each Additional Branch Of A Major Coronary Artery (List Separately In Addition To Code For Primary Procedure) |
| 92924-CPT | Moderate | Percutaneous Transluminal Coronary Atherectomy With Coronary Angioplasty When Performed; Single Major Coronary Artery Or Branch |
| 92928-CPT | Moderate | Percutaneous Transcatheter Placement Of Intracoronary Stent(S) With Coronary Angioplasty When Performed; Single Major Coronary Artery Or Branch |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92920 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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