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See a sample rate comparisonCPT 92961 Fee Schedule
Last Verified: October 2026
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.
Electric Shock For Heartbeat, An Electrical Charge Delivered Into The Heart Muscle In Order To Reset The Heartbeat To A Different Rhythm.
| 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 | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $215.44 national non-facility rate (2026) · View Medicare rates for 92961 |
| Medicaid Fee Schedule | $168.59 median of the 8 states in the free preview · View Medicaid rates for 92961 |
National average reimbursement for CPT 92961 by major payers:
$324.09
$334.88
$330.29
$394.05
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CPT 92961
5 of 25 sample ratesHigher to lower in this preview
Valley Baptist Medical Center
$5,566.00Published rateProvidence Health & Services Oregon, Providence Portland Medical Center
$2,765.00Published rateOsf Healthcare System, Osf Saint Anthony'S Health Center
Osf Healthcare System
$1,345.00Published rateAnderson Regional Medical Center, Anderson Regional Medical Center South Campus
Anderson Regional Medical Center
$784.00Published rateOxford Pre Op & Imaging Center LLC
Oxford Pre Op Imaging Center LLC
$189.66Published rate
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See a sample payer proposalCPT 92961 vs. Other Cardiovascular Procedures Codes
The CPT 92961 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 92961 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 |
|---|---|---|
| 92961-CPT | Moderate | Electric Shock For Heartbeat, An Electrical Charge Delivered Into The Heart Muscle In Order To Reset The Heartbeat To A Different Rhythm. |
| 92970-CPT | Moderate | Heart-Assist Procedure, A Procedure To Place A Device Around The Abdomen Or Legs That Provides Resistance To Help With Circulation. |
| 92971-CPT | Low | Heart-Assist Procedure, A Procedure To Place A Device Around The Abdomen Or Legs That Provides Resistance To Help With Circulation. |
| 92978-CPT | Moderate | Endoluminal Imaging Of Coronary Vessel Or Graft Using Intravascular Ultrasound (Ivus) Or Optical Coherence Tomography (Oct) During Diagnostic Evaluation And/Or Therapeutic Intervention Including Imaging Supervision Interpretation And Report; Initial Vessel (List Separately In Addition To Code For Primary Procedure) (Desc Revised 1/1/2017) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92961. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92961 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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