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See a sample rate comparisonCPT 92972 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.
Percutaneous Transluminal Coronary Lithotripsy, Percutaneous Transluminal Coronary Lithotripsy (List Separately In Addition To Code For Primary Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Cardiovascular Procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $122.25 national non-facility rate (2026) · View Medicare rates for 92972 |
| Medicaid Fee Schedule | $119.60 median of the 8 states in the free preview · View Medicaid rates for 92972 |
National average reimbursement for CPT 92972 by major payers:
$203.99
$240.45
$1,127.22
$252.12
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CPT 92972
5 of 25 sample ratesHigher to lower in this preview
Lauren Schumacher
$933.28Published rateAngela Green
$297.88Published rateHuma Abbas
Advocate Health And Hospitals Corporation
$263.50Published rateCynthia Gordon
Illinois Professionals Health Progr
$198.02Published ratePatricia Wright
Town Center Orthopaedic Associates, P.C.
$135.17Published rate
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See a sample payer proposalCPT 92972 vs. Other Cardiovascular Procedures Codes
The CPT 92972 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 92972 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 |
|---|---|---|
| 92972-CPT | Moderate | Percutaneous Transluminal Coronary Lithotripsy, Percutaneous Transluminal Coronary Lithotripsy (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 92972. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92972 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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