CPT 92971 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 92971 |
National average reimbursement for CPT 92971 by major payers:
$126.79
$133.70
$126.88
$157.86
| 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 92971 | ||||||
United | 92971 | $5739.00 | 1538382239 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN MEMORIAL CITY CICD | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | General Acute Care Hospital (282N00000X) |
United | 92971 | $503.00 | 1386367506 - SEVIER COUNTY MEDICAL CENTER | 853389374 - (AR) SEVIER COUNTY MEDICAL CENTER | AR | Critical Access Hospital (282NC0060X) |
United | 92971 | $1621.00 | 1104812684 - JOHNSTON MEMORIAL HOSPITAL, INC | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 92971 | $2377.00 | 1205877172 - MVHS INC, WYNN HOSPITAL | 161576637 - FAXTON-ST LUKES HEALTHCARE | NY | General Acute Care Hospital (282N00000X) |
United | 92971 | $1397.00 | 1700961869 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 92971 | $436.00 | 1184363186 - SHORE HEALTH SYSTEM, INC | 372002744 | MD | Radiology Clinic/Center (261QR0200X) |
United | 92971 | $3585.00 | 1871530832 - CENTRAL TENNESSEE HOSPITAL CORPORATION, TRISTAR HORIZON MEDICAL CENTER | 621620866 - (TN) CENTRAL TENNESSEE HOSPITAL CORPORATION | TN | General Acute Care Hospital (282N00000X) |
United | 92971 | $3956.00 | 1457321036 - PHC-CLEVELAND LLC, BOLIVAR MEDICAL CENTER | 621812558 | MS | General Acute Care Hospital (282N00000X) |
United | 92971 | $5833.89 | 1548047616 - INTEGRIS HEALTH PONCA CITY HOSPITAL INC, INTEGRIS HEALTH PONCA CITY HOSPITAL | 932949739 | OK | General Acute Care Hospital (282N00000X) |
United | 92971 | $1055.00 | 1619973542 - SOUTH CENTRAL REGIONAL MEDICAL CENTER | 646001540 - (MS) SOUTH CENTRAL REGIONAL MEDICAL CENTER | MS | General Acute Care Hospital (282N00000X) |
United | 92971 | $5588.00 | 1639116726 - WEST FLORIDA REGIONAL MEDICAL CENTER, INC., HCA FLORIDA WEST HOSPITAL | 591525468 - (FL) WEST FLORIDA REGIONAL MEDICAL CENTER INC | FL | General Acute Care Hospital (282N00000X) |
United | 92971 | $6836.00 | 1194762294 - HCA HEALTH SERVICES OF VIRGINIA INC, HENRICO DOCTORS' HOSPITAL | 621113733 | VA | General Acute Care Hospital (282N00000X) |
United | 92971 | $4480.00 | 1770573586 - MCALLEN HOSPITALS L P, SOUTH TEXAS HEALTH SYSTEM | 233069260 | TX | General Acute Care Hospital (282N00000X) |
United | 92971 | $6313.00 | 1023705803 - NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING, HSS SOUTHAMPTON | 131624135 - NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING | NY | Radiology Clinic/Center (261QR0200X) |
United | 92971 | $1177.00 | 1598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER | 760714523 | TX | 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 92971 vs. Other Cardiovascular Procedures Codes
The CPT 92971 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 92971 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) |
| 92975-CPT | Moderate | Thrombolys,Coronary;Intracor.Infusn |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92971. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92971 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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