CPT 92928 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 • RC - Right coronary artery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 92928 |
National average reimbursement for CPT 92928 by major payers:
$780.37
$819.92
$788.30
$964.28
| 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 92928 | ||||||
United | 92928 | $7468.00 | 1194770404 - MADISON HMA LLC, MERIT HEALTH MADISON | 30400182 - (MS) MADISON HMA LLC | MS | General Acute Care Hospital (282N00000X) |
United | 92928 | $862.03 | 1003295403 - MRI & IMAGING OF GEORGIA, LLC | 473958809 | GA | Radiology Clinic/Center (261QR0200X) |
United | 92928 | $6681.00 | 1376139139 - NOVANT HEALTH NEW HANOVER REGIONAL MEDICAL CENTER LLC, NOVANT HEALTH NEW HANOVER REGIONAL MEDICAL CENTER | 853777599 | NC | General Acute Care Hospital (282N00000X) |
United | 92928 | $3077.00 | 1285664177 - MERCY HOSPITALS EAST COMMUNITIES, MERCY HOSPITAL WASHINGTON | 431066883 - (MO) MERCY HOSPITALS EAST COMMUNITIES | MO | General Acute Care Hospital (282N00000X) |
United | 92928 | $14457.00 | 1093791170 - HOSPITAL DEVELOPMENT OF WEST PHOENIX INC, ABRAZO WEST CAMPUS AND ABRAZO MARYVALE CAMPUS | 621867232 - (AZ) HOSPITAL DEVELOPMENT OF WEST PHOENIX INC | AZ | General Acute Care Hospital (282N00000X) |
United | 92928 | $4747.00 | 1669962593 - UKHS GREAT BEND, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM GREAT BEND CAMPUS | 830516935 | KS | General Acute Care Hospital (282N00000X) |
United | 92928 | $7492.00 | 1205882669 - BRANDON HMA LLC, MERIT HEALTH RANKIN | 640885458 | MS | General Acute Care Hospital (282N00000X) |
United | 92928 | $13183.00 | 1811994809 - AHS HOSPITAL CORP., CHILTON MEDICAL CENTER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 92928 | $23091.00 | 1528075108 - FRANKLIN HOSPITAL | 112241326 - LONG ISLAND JEWISH MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 92928 | $23645.00 | 1316177413 - NORTHSHORE UNIVERSITY HEALTHSYSTEM | 362167060 - (IL) NORTHSHORE UNIVERSITY HEALTHSYSTEM | IL | General Acute Care Hospital (282N00000X) |
United | 92928 | $6262.00 | 1083286801 - STEWARD CGH, INC. | 862608394 | FL | General Acute Care Hospital (282N00000X) |
United | 92928 | $18262.00 | 1649563065 - RADY CHILDREN'S HOSPITAL SAN DIEGO, DEVELOPMENTAL EVAL CLINIC - TORREY HILLS SATELLITE | 951691313 - RADY CHILDRENS HOSPITAL-SAN DIEGO | CA | General Acute Care Hospital (282N00000X) |
United | 92928 | $57978.00 | 1912249590 - PORTERCARE ADVENTIST HEALTH SYSTEM, ADVENTHEALTH CASTLE ROCK | 840438224 - PORTERCARE ADVENTIST HEALTH SYSTEM | CO | General Acute Care Hospital (282N00000X) |
United | 92928 | $1618.00 | 1811566540 - SHAMROCK COMMUNITY HOSPITAL INC, HOUSTON COUNTY COMMUNITY HOSPITAL | 862345211 | TN | Critical Access Hospital (282NC0060X) |
United | 92928 | $14460.00 | 1760567085 - STARR COUNTY HOSPITAL DISTRICT, STARR COUNTY MEMORIAL HOSPITAL | 741794256 | TX | Rural Acute Care Hospital (282NR1301X) |
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 92928 vs. Other Cardiovascular Procedures Codes
The CPT 92928 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 92928 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 92928. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92928 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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