CPT 92960 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 | Other Therapeutic Cardiovascular Services and Procedures Therapeutic Cardiovascular Services and Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 92960 |
National average reimbursement for CPT 92960 by major payers:

$231.41

$256.83

$266.31

$189.46
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 92960 | $105.98 | 1255355400 - ROBERT MALOVANY | 223404410 - (NJ) BERGEN MEDICAL ALLIANCE PA | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $293.02 | 1710929898 - ZHEXIANG LI | 274980253 - (NJ) PRIMARY CARE PARTNERS, LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $194.46 | 1780771626 - JEFFREY GONG | 222720159 | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $192.03 | 1629013933 - LIVIU RAPPAPORT | 274980253 - (NJ) PRIMARY CARE PARTNERS, LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $377.76 | 1851442206 - STEVEN DELMAESTRO | 853737205 | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $162.14 | 1376598136 - YELENA BIRGER | 1376598136 - (NJ) YELENA BIRGER | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $197.42 | 1255332789 - GHASSAN WARDEH | 831501663 - (NJ) ESCALES MEDICAL ASSOCIATES AT WAYNE LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $293.02 | 1457411019 - JAMES HAKIM | 274980253 - (NJ) PRIMARY CARE PARTNERS, LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $388.26 | 1538543988 - CAROLINA MEDRANO MENDEZ | 853737205 | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $349.42 | 1013330018 - ADAM KAPLAN | 853737205 | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $149.63 | 1447504378 - ZESHAN LATIF | 203297341 - (NJ) SHAHIDA ABBAS MD LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $140.82 | 1447504378 - ZESHAN LATIF | 203297341 - (NJ) SHAHIDA ABBAS MD LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $293.02 | 1538228432 - H. BURNS | 274980253 - (NJ) PRIMARY CARE PARTNERS, LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $388.26 | 1972986917 - RASHI SHARMA | 853737205 | NJ | Internal Medicine Physician (207R00000X) |
United | 92960 | $153.77 | 1376598136 - YELENA BIRGER | 1376598136 - (NJ) YELENA BIRGER | NJ | Internal Medicine Physician (207R00000X) |
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 92960 vs. Other Therapeutic Cardiovascular Services and Procedures Codes
The CPT 92960 code is part of the Other Therapeutic Cardiovascular 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 92960 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 |
| 92924-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. |
| 92941-CPT | Moderate | Cardiovascular Surgery, Percutaneous Transluminal Revascularization Of Acute Total/Subtotal Occlusion During Acute Myocardial Infarction Coronary Artery Or Coronary Artery Bypass Graft Any Combination Of Intracoronary Stent Atherectomy And Angioplasty Including Aspiration Thrombectomy When Performed Single Vessel Major Coronary Artery And/Or Its Branches Or Single Bypass Graft And/Or Its Subtended Branches |
| 92960-CPT | Moderate | Electric Shock For Heartbeat, An Electrical Charge Delivered Into The Heart Muscle In Order To Reset The Heartbeat To A Different Rhythm. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92960. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92960 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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