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See a sample rate comparisonCPT 92970 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.
Heart-Assist Procedure, A Procedure To Place A Device Around The Abdomen Or Legs That Provides Resistance To Help With Circulation.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Cardiovascular Procedures |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 26 - Professional component 73 - Discontinued Outpatient Services LD - Left anterior descending coronary artery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $163.00 national non-facility rate (2026) · View Medicare rates for 92970 |
| Medicaid Fee Schedule | $142.535 median of the 8 states in the free preview · View Medicaid rates for 92970 |
National average reimbursement for CPT 92970 by major payers:
$238.96
$248.28
$233.52
$294.46
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CPT 92970
5 of 25 sample ratesHigher to lower in this preview
Gpch-Gp, Inc., Garden Park Medical Center
Gpchgp Inc
$11,791.00Published rateWestchester County Health Care Corporation, Westchester Medical Center
Peo Mid-Hudson Valley Staffco
$6,167.00Published rateHca Health Services Of Georgia, Inc., Hughston Orthopedic Hospital
Hughston Hospital Inc
$3,687.00Published rateThedacare Medical Center, Riverside Medical Center, Inc.
Thedacare Medical Center-Waupaca Inc
$2,429.00Published rateCarolina Radiology Associates LLC
Carolina Radiology Associates, LLC
$155.11Published rate
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See a sample payer proposalCPT 92970 vs. Other Cardiovascular Procedures Codes
The CPT 92970 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 92970 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 |
|---|---|---|
| 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. |
| 92973-CPT | Moderate | Remove Clot From Heart Artery, Procedure To Flush A Blood Clot Out Of A Blood Vessel. A High-Pressure Saline Stream (Via A Pump) Is Used To Break Up The Clot Into Small Pieces And Push It Through The Catheter (Tube) And Out Of The Body. |
| 92974-CPT | Moderate | Place Radiation Therapy Tool, Insertion Of A Catheter (Tube) That Will Be Used To Place Radioactive Seeds Into The Heart Artery For Brachytherapy. Brachytherapy Implants Tiny Radioactive Particles (Seeds) Near A Tumor. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92970. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92970 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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