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 |
| Medicare Fee Schedule | View Medicare rates for 92920 |
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 | $11621.00 | 1619935640 - METRO WEST | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $12141.00 | 1710097936 - OCHSNER MEDICAL CENTER | 205432782 | LA | General Acute Care Hospital (282N00000X) |
United | 92920 | $16083.00 | 1922344167 - TEXAS HEALTH ARLINGTON MEMORIAL | 750972805 - (TX) TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $1169.71 | 1730556259 - RAM SAHA | 541581185 - MCV ASSOCIATED PHYSICIANS | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $17046.00 | 1649488511 - TOURO INFIRMARY ANESTHESIA SERVICES | 720423659 - (LA) TOURO INFIRMARY | LA | General Acute Care Hospital (282N00000X) |
United | 92920 | $24812.00 | 1609855139 - TEXAS HEART HOSPITAL OF THE SOUTHWEST, LLC, BAYLOR SCOTT & WHITE HEART AND VASCULAR HOSPITAL - DALLAS | 752834135 - (TX) BAYLOR HEART & VASCULAR HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $20611.00 | 1922344167 - TEXAS HEALTH ARLINGTON MEMORIAL | 750972805 - (TX) TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $5300.00 | 1215996632 - PARK PLACE SURGERY CENTER, LLC, PARK PLACE SURGICAL HOSPITAL | 721404092 - (LA) PARK PLACE SURGICAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 92920 | $9935.00 | 1134166192 - ORTHOPEDIC HOSPITAL LTD, TEXAS ORTHOPEDIC HOSPITAL | 760418502 - (TX) ORTHOPEDIC HOSPITAL LTD | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $3149.00 | 1265437743 - REGIONAL UROLOGY ASC LLC | 721455456 - (LA) REGIONAL UROLOGY ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 92920 | $4558.00 | 1215996632 - PARK PLACE SURGERY CENTER, LLC, PARK PLACE SURGICAL HOSPITAL | 721404092 - (LA) PARK PLACE SURGICAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 92920 | $767.52 | 1275581852 - ROLLING PLAINS MEMORIAL HOSPITAL | 756003896 - (TX) THE NOLAN COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 92920 | $2412.00 | 1780865634 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND TERAPEUTIC CENTER | 205904604 | 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 | $18756.00 | 1356960132 - TEXAS HEALTH HOSPITAL MANSFIELD | 831869297 - (TX) TEXAS HEALTH HOSPITAL MANSFIELD | 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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