CPT 92970 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 • 11 - Office |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 26 - Professional component • 73 - Discontinued Outpatient Services • LD - Left anterior descending coronary artery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 92970 |
National average reimbursement for CPT 92970 by major payers:
$238.96
$248.28
$233.52
$297.00
| 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 92970 | ||||||
United | 92970 | $525.00 | 1215194204 - ALLEN PARISH HOSPITAL DISTRICT NO 3, ALLEN PARISH HOSPITAL | 720655439 | LA | General Acute Care Hospital (282N00000X) |
United | 92970 | $11791.00 | 1598719577 - GPCH-GP, INC., GARDEN PARK MEDICAL CENTER | 640805500 - (MS) GPCHGP INC | MS | General Acute Care Hospital (282N00000X) |
United | 92970 | $1422.00 | 1073576740 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, VALLEYWISE HEALTH | 860830701 | AZ | General Acute Care Hospital (282N00000X) |
United | 92970 | $4660.00 | 1821074196 - BOULDER COMMUNITY HEALTH, THE COMMUNITY HOSPITAL ASSOCIATION | 840175870 - BOULDER COMMUNITY HEALTH | CO | General Acute Care Hospital (282N00000X) |
United | 92970 | $6410.00 | 1225589245 - FRANCISCAN HEALTH INDIANAPOLIS | 350913537 | IN | General Acute Care Hospital (282N00000X) |
United | 92970 | $6314.00 | 1124218367 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP, METHODIST SPECIALTY AND TRANSPLANT HOSPITAL | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 92970 | $2647.00 | 1114473329 - EMERUS BHS SA THOUSAND OAKS LLC, BAPTIST NEIGHBORHOOD HOSPITAL SHAVANO PARK | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 92970 | $7101.00 | 1528014669 - PALMS WEST HOSPITAL LIMITED PARTNERSHIP, HCA FLORIDA PALMS WEST HOSPITAL | 621694178 - (FL) PALMS WEST HOSPITAL LIMITED PARTNERSHIP | FL | General Acute Care Hospital (282N00000X) |
United | 92970 | $2648.00 | 1265465439 - ADVENTIST MIDWEST HEALTH, UCHICAGO MEDICINE ADVENTHEALTH HINSDALE | 362276984 - ADVENTIST MIDWEST HEALTH | IL | General Acute Care Hospital (282N00000X) |
United | 92970 | $1891.00 | 1992813240 - MOUNTAIN STATES HEALTH ALLIANCE, INDIAN PATH COMMUNITY HOSPITAL | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | TN | General Acute Care Hospital (282N00000X) |
United | 92970 | $4096.39 | 1649246877 - ST MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC.-HOSPITAL SISTERS | 390818682 - ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC-HOSPITAL SISTERS | WI | General Acute Care Hospital (282N00000X) |
United | 92970 | $6167.00 | 1932280666 - WESTCHESTER COUNTY HEALTH CARE CORPORATION, WESTCHESTER MEDICAL CENTER | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | General Acute Care Hospital (282N00000X) |
United | 92970 | $3687.00 | 1437102605 - HCA HEALTH SERVICES OF GEORGIA, INC., HUGHSTON ORTHOPEDIC HOSPITAL | 331216751 - (GA) HUGHSTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 92970 | $3775.00 | 1043213911 - CONDELL MEDICAL CENTER | 262525968 - (IL) ADVOCATE HEALTH CARE NETWORK | IL | General Acute Care Hospital (282N00000X) |
United | 92970 | $3100.00 | 1790376564 - VIDALIA HEALTH SERVICES, LLC | 852556972 | GA | 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 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 | Cardioassist-Method--Circ.;Internal |
| 92971-CPT | Low | Cardioassist-Method--Circ.;External |
| 92973-CPT | Moderate | Percutaneous Transluminal Coronary Thrombectomy Mechanical (List Separately In Addition To Code For Primary Procedure) (Revised 1/1/13) |
| 92974-CPT | Moderate | Transcatheter Placement Of Radiation Delivery Device For Subsequent Coronary Intravascular Brachytherapy (List Separately In Addition To Code For Primary Procedure) |
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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