CPT 92975 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 • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 92975 by major payers:
$516.89
$521.89
$486.69
$609.25
| 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 92975 | ||||||
United | 92975 | $374.95 | 1457345910 - BRADLEY SMITH | 561079264 - EMERGEORTHO, P.A. | NC | Orthopaedic Surgery Physician (207X00000X) |
United | 92975 | $374.95 | 1457345910 - BRADLEY SMITH | 561079264 - EMERGEORTHO, P.A. | NC | Orthopaedic Surgery Physician (207X00000X) |
United | 92975 | $3181.00 | 1578670543 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE GOOD SAMARITAN HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 92975 | $615.00 | 1548284177 - WESTCHESTER GENERAL HOSPITAL, INC., KERALTY HOSPITAL | 591201323 - (FL) WESTCHESTER GENERAL HOSPITAL, INC. | FL | General Acute Care Hospital (282N00000X) |
United | 92975 | $3181.00 | 1023308608 - ADVOCATE LUTHERAN GENERAL HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Children's Hospital (282NC2000X) |
United | 92975 | $2263.00 | 1932284411 - FOUNDATION BARIATRIC HOSPITAL OF SAN ANTONIO, LLC, FOUNDATION SURGICAL HOSPITAL OF SAN ANTONIO | 203793927 - (TX) FOUNDATION BARIATRIC HOSPITAL OF SAN ANTONIO LLC | TX | General Acute Care Hospital (282N00000X) |
United | 92975 | $5672.00 | 1932280666 - WESTCHESTER COUNTY HEALTH CARE CORPORATION, WESTCHESTER MEDICAL CENTER | 133964321 - (NY) PEO MID-HUDSON VALLEY STAFFCO | NY | General Acute Care Hospital (282N00000X) |
United | 92975 | $2062.00 | 1659523132 - THE METHODIST HOSPITAL, THE METHODIST HOSPITAL | 350868133 - METHODIST HOSPITALS INC | IN | General Acute Care Hospital (282N00000X) |
United | 92975 | $3034.00 | 1619911104 - JOHNSTON HEALTH SERVICES CORPORATION, JOHNSTON HEALTH | 463176429 - (NC) JOHNSTON HEALTH SERVICES CORPORATION | NC | General Acute Care Hospital (282N00000X) |
United | 92975 | $6281.00 | 1437713856 - HCA-HEALTHONE LLC, CENTENNIAL HOSPITAL | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 92975 | $19677.00 | 1861447179 - AURORA HEALTH CARE METRO, INC. | 390806181 - AURORA HEALTH CARE INC | WI | General Acute Care Hospital (282N00000X) |
United | 92975 | $4765.00 | 1811973100 - OCHSNER CLINIC FOUNDATION, OCHSNER MEDICAL CENTER ACUTE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 92975 | $4512.00 | 1184615114 - WATERBURY HOSPITAL | 812181470 - (CT) PROSPECT WATERBURY, INC. | CT | General Acute Care Hospital (282N00000X) |
United | 92975 | $1795.00 | 1609983790 - MONMOUTH MEDICAL CENTER INC | 223452412 | NJ | General Acute Care Hospital (282N00000X) |
United | 92975 | $5681.00 | 1386746592 - KENNEDY UNIVERSITY HOSPITAL INC. | 221773439 - (NJ) KENNEDY UNIVERSITY HOSPITAL INC | NJ | 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 92975 vs. Other Cardiovascular Procedures Codes
The CPT 92975 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 92975 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) |
| 92975-CPT | Moderate | Thrombolys,Coronary;Intracor.Infusn |
| 92977-CPT | Low | Thrombolysis Coronary-Iv Infusion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92975. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92975 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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