CPT 92921 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 92921 |
National average reimbursement for CPT 92921 by major payers:
$961.42
$451.32
$350.36
$1,002.91
| 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 92921 | ||||||
United | 92921 | $8925.00 | 1720373103 - INTEGRIS HEALTH EDMOND, INC, INTEGRIS HEALTH EDMOND HOSPITAL | 451027361 - (OK) INTEGRIS HEALTH EDMOND INC | OK | General Acute Care Hospital (282N00000X) |
United | 92921 | $51153.00 | 1548378235 - MEDSTAR WASHINGTON HOSPITAL CENTER | 521931000 | DC | General Acute Care Hospital (282N00000X) |
United | 92921 | $13827.70 | 1366545311 - SSM HEALTH CARE OF OKLAHOMA, INC., SSM HEALTH ST. ANTHONY HOSPITAL - OKLAHOMA CITY | 730657693 - SSM HEALTH CARE OF OKLAHOMA INC | OK | General Acute Care Hospital (282N00000X) |
United | 92921 | $9406.00 | 1033114608 - MEMORIAL HERMANN SUGAR LAND SURGICAL HOSPITAL, LLP, MEMORIAL HERMANN SURGICAL HOSPITAL FIRST COLONY | 352167462 - (TX) MEMORIAL HERMANN SUGAR LAND SURGICAL HOSPITAL LLP | TX | General Acute Care Hospital (282N00000X) |
United | 92921 | $3515.00 | 1902822992 - NASSAU HEALTHCARE CORPORATION, NASSAU DEPARTMENT OF PSYCHIATRY AND PSYCHOLOGY, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 92921 | $6035.00 | 1356399539 - FRANKLIN PARISH HOSPITAL SERVICE DISTRICT NO1, FRANKLIN MEDICAL CENTER | 720685044 - (LA) FRANKLIN MEDICAL CENTER EMPLOYEE BENEFIT PLAN TRUST | LA | Rural Acute Care Hospital (282NR1301X) |
United | 92921 | $17726.00 | 1336221019 - SOUTH LAKE HOSPITAL, INC. | 593322533 - (FL) SOUTH LAKE HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 92921 | $1679.00 | 1285835561 - BIENVILLE MEDICAL CENTER INC | 743227578 | LA | Critical Access Hospital (282NC0060X) |
United | 92921 | $1704.00 | 1699770149 - MUENSTER HOSPITAL DISTRICT, MUENSTER MEMORIAL HOSPITAL | 751244289 - (TX) MUENSTER HOSPITAL DISTRICT | TX | Critical Access Hospital (282NC0060X) |
United | 92921 | $22806.00 | 1376071530 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., LLP, METHODIST HOSPITAL ATASCOSA | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 92921 | $5682.00 | 1689714255 - PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NON-PROFIT CORPORATION, PENN MEDICINE PRINCETON MEDICAL CENTER | 210635009 - PRINCETON HEALTHCARE SYSTEM A NEW JERSEY NON-PROFIT CORP | NJ | General Acute Care Hospital (282N00000X) |
United | 92921 | $8627.00 | 1013995521 - THEDACARE MEDICAL CENTER, RIVERSIDE MEDICAL CENTER, INC. | 390871113 - (WI) THEDACARE MEDICAL CENTER-WAUPACA INC | WI | Critical Access Hospital (282NC0060X) |
United | 92921 | $3811.00 | 1063468072 - UNIVERSITY OF SOUTH ALABAMA, USA HEALTH UNIVERSITY HOSPITAL | 630477348 - UNIVERSITY OF SOUTH ALABAMA | AL | General Acute Care Hospital (282N00000X) |
United | 92921 | $11632.00 | 1659523132 - THE METHODIST HOSPITAL, THE METHODIST HOSPITAL | 350868133 - METHODIST HOSPITALS INC | IN | General Acute Care Hospital (282N00000X) |
United | 92921 | $7211.00 | 1922487966 - SAINT THOMAS HIGHLANDS HOSPITAL, LLC, ASCENSION SAINT THOMAS HIGHLANDS | 474063406 | TN | 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 92921 vs. Other Cardiovascular Procedures Codes
The CPT 92921 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 92921 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 |
| 92925-CPT | Moderate | Percutaneous Transluminal Coronary Atherectomy With Coronary Angioplasty When Performed; Each Additional Branch Of A Major Coronary Artery (Listseparately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92921. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92921 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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