CPT 92978 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 | • 26 - Professional component • None • LD - Left anterior descending coronary artery |
| Complexity Level | Moderate |
National average reimbursement for CPT 92978 by major payers:
$299.15
$374.47
$345.68
$458.28
| 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 92978 | ||||||
United | 92978 | $164.02 | 1013964113 - EYECARE ASSOCIATES PC | 930590581 - EYECARE ASSOCIATES PC | OR | Ophthalmology Physician (207W00000X) |
United | 92978 | $326.39 | 1013964113 - EYECARE ASSOCIATES PC | 930590581 - EYECARE ASSOCIATES PC | OR | Ophthalmology Physician (207W00000X) |
United | 92978 | $220.03 | 1598729105 - JEFFREY ANDERSON | 630837257 - (AL) CARDIOLOGY CONSULTANTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92978 | $190.02 | 1588109599 - CITRIN CARDIOLOGY PC | 814661745 - (AL) CITRIN CARDIOLOGY PC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92978 | $326.39 | 1013964113 - EYECARE ASSOCIATES PC | 930590581 - EYECARE ASSOCIATES PC | OR | Ophthalmology Physician (207W00000X) |
United | 92978 | $490.41 | 1013964113 - EYECARE ASSOCIATES PC | 930590581 - EYECARE ASSOCIATES PC | OR | Ophthalmology Physician (207W00000X) |
United | 92978 | $188.33 | 1487858072 - GHASSAN ABUSAID | 272451336 | TX | Interventional Cardiology Physician (207RI0011X) |
United | 92978 | $265.73 | 1548224157 - CARDIOLOGY CONSULTANTS PC | 630837257 - (AL) CARDIOLOGY CONSULTANTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92978 | $165.61 | 1174781017 - KEVIN DEANDRADE | 631159436 - (AL) MOBILE HEART SPECIALISTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92978 | $520.09 | 1205957198 - BILAL AIJAZ | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Interventional Cardiology Physician (207RI0011X) |
United | 92978 | $283.98 | 1659311736 - MICHAEL MONSON | 631205990 - (AL) RIHNER, GUPTA AND GROSZ CARDIOLOGY, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 92978 | $1772.00 | 1669472387 - BAYLOR ALL SAINTS MEDICAL CENTER, BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | 751008430 - (TX) BAYLOR ALL SAINTS MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 92978 | $1969.00 | 1942348354 - BAYLOR UNIVERSITY MEDICAL CENTER | 751837454 - (TX) BAYLOR UNIVERSITY MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 92978 | $1676.00 | 1710314141 - ST. LUKES HOSPITAL AT THE VINTAGE | 263734606 - (TX) ST LUKES HOSPITAL AT THE VINTAGE | TX | General Acute Care Hospital (282N00000X) |
United | 92978 | $209.30 | 1336172105 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 756001743 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | TX | 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 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 | Cardioassist-Method--Circ.;Internal |
| 92971-CPT | Low | Cardioassist-Method--Circ.;External |
| 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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