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See a sample rate comparisonCPT 92978 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.
Endoluminal Imaging Of Coronary Vessel Or Graft Using Intravascular Ultrasound (Ivus) Or Optical Coherence Tomography (Oct) During Diagnostic Evaluation And/Or Therapeutic Intervention Including Imaging Supervision Interpretation And Report; Initial Vessel (List Separately In Addition To Code For Primary Procedure) (Desc Revised 1/1/2017)
| 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 | 26 - Professional component LD - Left anterior descending coronary artery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $92.86 national non-facility rate (2026) · View Medicare rates for 92978 |
| Medicaid Fee Schedule | $167.96 median of the 5 states in the free preview · View Medicaid rates for 92978 |
National average reimbursement for CPT 92978 by major payers:
$299.15
$374.47
$345.68
$447.24
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CPT 92978
5 of 25 sample ratesHigher to lower in this preview
Bay Area Healthcare Group, Ltd., Corpus Christi Medical Center
$2,169.00Published rateTrophy Club Medical Center Lp, Baylor Scott & White Medical Center - Trophy Club
Trophy Club Medical Center Lp
$1,571.00Published rateOrthopedic & Spine Surgical Hospital Of South Texas, L.P., South Texas Spine & Surgical Hospital
$895.00Published rateEl Paso County Hospital District, University Medical Center Of El Paso
El Paso County Hospital District
$354.95Published rateJones County Regional Healthcare System, Stamford Memorial Hospital
Jones County Regional Healthcare System
$129.80Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 92978 vs. Other Cardiovascular Procedures Codes
The CPT 92978 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 92978 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 | Heart-Assist Procedure, A Procedure To Place A Device Around The Abdomen Or Legs That Provides Resistance To Help With Circulation. |
| 92971-CPT | Low | Heart-Assist Procedure, A Procedure To Place A Device Around The Abdomen Or Legs That Provides Resistance To Help With Circulation. |
| 92978-CPT | Moderate | Endoluminal Imaging Of Coronary Vessel Or Graft Using Intravascular Ultrasound (Ivus) Or Optical Coherence Tomography (Oct) During Diagnostic Evaluation And/Or Therapeutic Intervention Including Imaging Supervision Interpretation And Report; Initial Vessel (List Separately In Addition To Code For Primary Procedure) (Desc Revised 1/1/2017) |
| 92979-CPT | Low | Endoluminal Imaging Of Coronary Vessel Or Graft Using Intravascular Ultrasound (Ivus) Or Optical Coherence Tomography (Oct) During Diagnostic Evaluation And/Or Therapeutic Intervention Including Imaging Supervision Interpretation And Report; Each Additional Vessel (List Separately Inaddition To Code For Primary Procedure) (Desc Revised 1/1/2017) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92978. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92978 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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Frequently Asked Questions
CPT (Current Procedural Terminology) codes are a medical code set used by physicians, allied health professionals, non-physician practitioners, hospitals, and other healthcare providers to report medical, surgical, and diagnostic procedures and services to entities such as physicians' offices, hospitals, and outpatient facilities.
The cost of medical procedures can vary significantly based on the provider, location, and your insurance coverage. To get an estimate for a specific CPT code and your location, you can use tools like Payerprice, which offers a fee schedule lookup tool. It's also recommended to contact your insurance provider directly for details on your specific plan benefits.
An in-network provider has a contract with your insurance company to provide services at pre-negotiated rates, typically resulting in lower out-of-pocket costs for you. An out-of-network provider does not have such an agreement, which means you may pay a higher percentage of the cost, or even the full cost, depending on your plan.
Medical bills can be complex. Key sections to look for include the date of service, description of services (often with CPT codes), billed amount, allowed amount (if insured), patient responsibility, and any payments made. Always compare your bill with the Explanation of Benefits (EOB) from your insurance company to ensure accuracy. If you have questions, contact the provider's billing department or your insurance company.
A fee schedule is a complete listing of fees used by an insurance plan or medical provider to pay for services. It outlines the maximum allowable amount that an insurer will pay for a specific medical procedure or service, often based on CPT codes. Providers also use fee schedules to set their prices for services.