CPT 92973 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RC - Right coronary artery • LD - Left anterior descending coronary artery |
| Complexity Level | Moderate |
National average reimbursement for CPT 92973 by major payers:
$242.86
$239.12
$238.09
$282.68
| 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 92973 | ||||||
United | 92973 | $1550.00 | 1912951963 - DOCTORS HOSPITAL OF AUGUSTA LLC, DOCTORS HOSPITAL (AUGUSTA) | 581162801 - (GA) DOCTORS HOSPITAL OF AUGUSTA LLC | GA | General Acute Care Hospital (282N00000X) |
United | 92973 | $13778.00 | 1275700874 - SACRAMENTO RADIOLOGY MEDICAL GROUP, INC. | 942761692 | CA | General Acute Care Hospital (282N00000X) |
United | 92973 | $3686.00 | 1912014564 - ADVOCATE NORTH SIDE HEALTH NETWORK, ADVOCATE ILLINOIS MASONIC MEDICAL CENTER | 363196629 - (IL) ADVOCATE NORTH SIDE HEALTH NETWORK | IL | General Acute Care Hospital (282N00000X) |
United | 92973 | $3686.00 | 1942750831 - ADVOCATE GOOD SAMARITAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 92973 | $643.00 | 1821002007 - UNIVERSITY OF CALIFORNIA IRVINE, UCI HEALTH - FOUNTAIN VALLEY | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | General Acute Care Hospital (282N00000X) |
United | 92973 | $1665.00 | 1902901333 - CLARA MAASS MEDICAL CENTER | 221500556 | NJ | General Acute Care Hospital (282N00000X) |
United | 92973 | $3321.00 | 1417106907 - OVERLOOK HOSPITAL | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 92973 | $1541.00 | 1346243375 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL, INC | 221487243 - (NJ) ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL | NJ | General Acute Care Hospital (282N00000X) |
United | 92973 | $363.00 | 1548471337 - TATTNALL COMMUNITY HOSPITAL, TATTNALL COMMUNITY HOSPITAL | 300466706 | GA | Critical Access Hospital (282NC0060X) |
United | 92973 | $3489.00 | 1982017125 - SAINT JOHNS EPISCOPAL HOSPITAL | 111665825 - (NY) EPISCOPAL HEALTH SERVICES INC | NY | General Acute Care Hospital (282N00000X) |
United | 92973 | $300.00 | 1750346151 - METRO HATO REY INC, HOSPITAL PAVIA HATO REY | 660677702 - (PR) METRO HATO REY INC | PR | General Acute Care Hospital (282N00000X) |
United | 92973 | $2741.00 | 1982650024 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR SUMMIT MEDICAL CENTER | 621113737 - HCA HEALTH SERVICES OF TENNESSEE INC | TN | General Acute Care Hospital (282N00000X) |
United | 92973 | $2050.00 | 1760427157 - VENICE HMA LLC, SHOREPOINT HEALTH VENICE | 201852812 - (FL) VENICE HMA LLC | FL | General Acute Care Hospital (282N00000X) |
United | 92973 | $1723.00 | 1659525236 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP, METHODIST HOSPITAL STONE OAK | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 92973 | $3248.00 | 1992776405 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR STONECREST MEDICAL CENTER | 621113737 - HCA HEALTH SERVICES OF TENNESSEE INC | TN | 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 92973 vs. Other Cardiovascular Procedures Codes
The CPT 92973 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 92973 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 92973. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92973 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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