CPT 92937 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 | Coronary Therapeutic Services and Procedures Therapeutic Cardiovascular Services and Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LC - Left circumflex coronary artery RC - Right coronary artery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 92937 |
National average reimbursement for CPT 92937 by major payers:
$828.73
$819.10
$786.14
$947.23
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 92937 | $4072.00 | 1619215357 - BAPTITIST HOSPITAL OF MIAMI | 590910342 - (FL) BAPTIST HOSPITAL OF MIAMI INC | FL | General Acute Care Hospital (282N00000X) |
United | 92937 | $8025.00 | 1700870672 - METHODIST MEDICAL CENTER | 620636239 - METHODIST MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 92937 | $11396.00 | 1508856535 - LANCASTER HOSPITAL CORPORATION, PALMDALE REGIONAL MEDICAL CENTER | 953565954 - (CA) LANCASTER HOSPITAL CORPORATION | CA | General Acute Care Hospital (282N00000X) |
United | 92937 | $8305.00 | 1760513980 - INOVA HEALTH CARE SERVICES, INOVA FAIR OAKS HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 92937 | $6482.00 | 1538667035 - CARTHAGE HOSPITAL, LLC | 824005981 | TX | General Acute Care Hospital (282N00000X) |
United | 92937 | $14391.00 | 1619467412 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY, UCHEALTH EMERGENCY ROOM - AURORA CENTRAL | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 92937 | $19633.00 | 1265486278 - EAST GEORGIA REGIONAL MEDICAL CENTER, LLC, EAST GEORGIA REGIONAL MEDICAL CENTER LLC | 582190713 - (GA) EAST GEORGIA REGIONAL MEDICAL CENTER LLC | GA | General Acute Care Hospital (282N00000X) |
United | 92937 | $10452.00 | 1285005140 - CONWAY COMMUNITY SERVICES, BAPTIST HEALTH MEDICAL CENTER - CONWAY | 461629800 - (AR) CONWAY COMMUNITY SERVICES | AR | General Acute Care Hospital (282N00000X) |
United | 92937 | $1261.97 | 1700816717 - DAYTON OUTPATIENT CENTER INC, DOC IMAGING SERVICES | 311642691 - (OH) DAYTON OUTPATIENT CENTER INC | OH | Radiology Clinic/Center (261QR0200X) |
United | 92937 | $7314.00 | 1699769901 - CURATORS OF THE UNIVERSITY OF MISSOURI, UNIVERSITY OF MISSOURI HEALTH CARE | 436003859 | MO | General Acute Care Hospital (282N00000X) |
United | 92937 | $2940.00 | 1992848857 - SHRINERS HOSPITALS FOR CHILDREN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | WA | Children's Hospital (282NC2000X) |
United | 92937 | $8467.00 | 1285689794 - CLARKSVILLE HEALTH SYSTEM GP, TENNOVA HEALTHCARE-CLARKSVILLE | 203500835 - (TN) CLARKSVILLE HEALTH SYSTEM GP | TN | General Acute Care Hospital (282N00000X) |
United | 92937 | $858.00 | 1306849617 - WEST ASCENSION PARISH HOSPITAL SERVICE DISTRICT, PREVOST MEMORIAL HOSPITAL | 720637478 | LA | Critical Access Hospital (282NC0060X) |
United | 92937 | $2940.00 | 1669513941 - SHRINERS HOSPITALS FOR CHILDREN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | TX | Children's Hospital (282NC2000X) |
United | 92937 | $14070.00 | 1386252112 - AHMC SETON MEDICAL CENTER LLC | 851126333 | CA | 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 92937 vs. Other Therapeutic Cardiovascular Services and Procedures Codes
The CPT 92937 code is part of the Coronary Therapeutic Services and Procedures services used for Therapeutic Cardiovascular Services and 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 92937 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 | Prq Cardiac Angioplast 1 Art, Balloon Dilation Of Narrowed Or Blocked Major Coronary Artery Or Branch (Accessed Through The Skin) Each Additional Artery Or Branch |
| 92928-CPT | Moderate | Prq Tcat Plmt Ntrac St 1 Les, Percutaneous Transcatheter Placement Of Intracoronary Stent(S) With Coronary Angioplasty When Performed Single Major Coronary Artery And/Or Its Branch(Es); 1 Lesion Involving 1 Or More Coronary Segments |
| 92933-CPT | Moderate | Treat Artery Blockage In Heart, Procedure To Remove Fatty Deposits On The Walls Of An Artery Of The Heart Obstructing The Flow Of Blood That Normally Nourishes The Heart Muscle. A Small Device May Be Used To Hold The Artery Open. The Device May Contain Medication To Be Released Over Time. |
| 92937-CPT | Moderate | Cardiovascular Surgery, Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass Graft (Internal Mammary Free Arterial Venous) Any Combination Of Intracoronary Stent Atherectomy And Angioplasty Including Distal Protection When Performed; Single Major Coronary Artery And/Or Its Branches Vessel |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92937. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92937 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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