CPT 92974 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • RC - Right coronary artery • LD - Left anterior descending coronary artery |
| Complexity Level | Moderate |
National average reimbursement for CPT 92974 by major payers:
$203.12
$219.27
$214.01
$259.48
| 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 92974 | ||||||
United | 92974 | $1851.00 | 1760427157 - VENICE HMA LLC, SHOREPOINT HEALTH VENICE | 201852812 - (FL) VENICE HMA LLC | FL | General Acute Care Hospital (282N00000X) |
United | 92974 | $455.00 | 1497003610 - CLAIBORNE COUNTY HOSPITAL | 460738609 | MS | Critical Access Hospital (282NC0060X) |
United | 92974 | $3262.00 | 1417980566 - MCKEE MEDICAL CENTER | 840826332 - (CO) MCKEE MEDICAL CENTER | CO | General Acute Care Hospital (282N00000X) |
United | 92974 | $1772.00 | 1972640316 - BAYLOR ALL SAINTS MEDICAL CENTER | 751008430 - (TX) BAYLOR ALL SAINTS MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 92974 | $1697.00 | 1639449994 - RADY CHILDREN'S HOSPITAL, KIDSTART CENTRAL | 951691313 - RADY CHILDRENS HOSPITAL-SAN DIEGO | CA | Children's Hospital (282NC2000X) |
United | 92974 | $4536.00 | 1336404169 - MANCHESTER MEMORIAL HOSPITAL | 812216981 | CT | General Acute Care Hospital (282N00000X) |
United | 92974 | $1789.00 | 1265740195 - AURORA MEDICAL CENTER GRAFTON, LLC | 272953799 - AURORA HEALTH CARE INC | WI | General Acute Care Hospital (282N00000X) |
United | 92974 | $1954.00 | 1437107208 - CASA GRANDE COMMUNITY HOSPITAL, CASA GRANDE REGIONAL MEDICAL CENTER | 450233470 - BANNER HEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 92974 | $1047.00 | 1114053782 - THE SHRINERS' HOSPITAL FOR CHILDREN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | MA | Children's Hospital (282NC2000X) |
United | 92974 | $4625.00 | 1609824010 - OREGON HEALTH & SCIENCE UNIVERSITY | 931176109 | OR | General Acute Care Hospital (282N00000X) |
United | 92974 | $183.00 | 1710355649 - JOHNSTON MEMORIAL HOSPITAL, INC, JOHNSTON MEMORIAL SLEEP LAB | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 92974 | $873.00 | 1952390643 - PROVIDENCE HOSPITAL | 931394239 - (AL) USA HEALTH HCA PROVIDENCE HOSPITAL LLC | AL | General Acute Care Hospital (282N00000X) |
United | 92974 | $1851.00 | 1437107208 - CASA GRANDE COMMUNITY HOSPITAL, CASA GRANDE REGIONAL MEDICAL CENTER | 450233470 - BANNER HEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 92974 | $204.00 | 1366506826 - AMERICAN LEGION HOSPITAL | 464958152 - (LA) ACADIA GENERAL HOSPITAL INC | LA | General Acute Care Hospital (282N00000X) |
United | 92974 | $933.00 | 1467504555 - THE METHODIST HOSPITALS, INC | 350868133 - METHODIST HOSPITALS INC | IN | 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 92974 vs. Other Cardiovascular Procedures Codes
The CPT 92974 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 92974 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 |
| 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) |
| 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 92974. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92974 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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