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 |
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 | $16561.00 | 1053328948 - SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER | 953522679 - SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER INC | CA | General Acute Care Hospital (282N00000X) |
United | 92921 | $22851.00 | 1982789046 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 92921 | $18756.00 | 1770514077 - TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO | 752770738 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO | TX | General Acute Care Hospital (282N00000X) |
United | 92921 | $5304.00 | 1609812700 - AHS HOSPITAL CORP., OVERLOOK HOSPITAL | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 92921 | $11664.00 | 1922003730 - RUSSELL COUNTY MEDICAL CENTER, INC, RUSSELL COUNTY MEDICAL CENTER | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | General Acute Care Hospital (282N00000X) |
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 | $15273.00 | 1801946090 - PATIENT FIRST CT, LLC, RESPONSE DIAGNOSTIC IMAGING | 203443100 - (VA) PATIENT FIRST CT LLC | VA | Radiology Clinic/Center (261QR0200X) |
United | 92921 | $17780.00 | 1568802288 - RAPIDES REGIONAL MEDICAL CENTER | 611267229 | LA | General Acute Care Hospital (282N00000X) |
United | 92921 | $18512.00 | 1619914785 - LEWIS-GALE MEDICAL CENTER, LLC, LEWISGALE MEDICAL CENTER | 621777534 | VA | General Acute Care Hospital (282N00000X) |
United | 92921 | $6995.00 | 1447303227 - GULF HEALTH HOSPITALS, INC, THOMAS HOSPITAL | 630891904 - (AL) GULF HEALTH HOSPITALS INC | AL | General Acute Care Hospital (282N00000X) |
United | 92921 | $9388.00 | 1215165832 - COOPER UNIVERSITY HOSPITAL | 210634462 - (NJ) COOPER HEALTH SYSTEM A NEW JERSEY NON-PROFIT CORPORATION | NJ | General Acute Care Hospital (282N00000X) |
United | 92921 | $13177.00 | 1053481630 - ANDERSON HOSPITAL, ANDERSON HOSPITAL | 370662561 - ANDERSON HOSPITAL | IL | 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 | $1091.00 | 1003026717 - FORREST COUNTY GENERAL HOSPITAL, PEARL RIVER COUNTY HOSPITAL | 646001587 - FORREST COUNTY GENERAL HOSPITAL | MS | Critical Access Hospital (282NC0060X) |
United | 92921 | $14115.00 | 1679903967 - EBD BEMC BURLESON, LLC, BAYLOR SCOTT & WHITE EMERGENCY HOSPITAL BURLESON | 364755936 | 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 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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