CPT 92986 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • GC - Service performed by resident under supervision • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 92986 |
National average reimbursement for CPT 92986 by major payers:
$1,675.81
$1,786.64
$1,833.96
$2,131.92
| 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 92986 | ||||||
United | 92986 | $15219.00 | 1598749707 - CHRISTUS HEALTH SOUTHEAST TEXAS, CHRISTUS SOUTHEAST TEXAS - JASPER MEMORIAL | 760591590 - (TX) CHRISTUS HEALTH SOUTHEAST TEXAS | TX | Rural Acute Care Hospital (282NR1301X) |
United | 92986 | $19308.00 | 1194122390 - PROVIDENCE ST. VINCENT MEDICAL CENTER | 930386929 - (OR) PROVIDENCE HEALTH & SERVICES OREGON | OR | General Acute Care Hospital (282N00000X) |
United | 92986 | $8707.00 | 1144205360 - MEMORIAL HOSPITAL OF TEXAS COUNTY AUTHORITY | 730725208 | OK | Critical Access Hospital (282NC0060X) |
United | 92986 | $1168.06 | 1285649095 - IMAGING PARTNERS OF MISSOURI, LLC | 870723291 - (MO) IMAGING PARTNERS OF MISSOURI LLC | MO | Radiology Clinic/Center (261QR0200X) |
United | 92986 | $2104.00 | 1285739581 - MENA HOSPITAL COMMISSION, MENA REGIONAL HEALTH SYSTEM | 710708660 - (AR) MENA HOSPITAL COMMISSION | AR | Rural Acute Care Hospital (282NR1301X) |
United | 92986 | $2391.51 | 1295952380 - OVERLOOK HOSPITAL, ATLANTIC HEALTH SYSTEMS | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | 92986 | $11271.00 | 1528488897 - LOYOLA UNIVERSITY MEDICAL CENTER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 92986 | $13851.00 | 1255387726 - BAYCARE AURORA, LLC, AURORA BAYCARE MEDICAL CENTER | 391947472 | WI | General Acute Care Hospital (282N00000X) |
United | 92986 | $5500.00 | 1992788772 - EAST JEFFERSON AMBULATORY SURGERY CENTER | 201425074 - (LA) EAST JEFFERSON AMBULATORY | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 92986 | $778.71 | 1619089398 - UNIVERSITY IMAGING CENTER, CHARLES E BUCKLEY, MD, PA | 521153709 - (MD) UNIVERSITY IMAGING CENTER CHARLES E BUCKLEY MD PA | MD | Radiology Clinic/Center (261QR0200X) |
United | 92986 | $15311.00 | 1396761805 - OCHSNER BAYOU LLC, OCHSNER ST. ANNE GENERAL HOSPITAL | 204670876 - (LA) OCHSNER BAYOU, LLC | LA | Critical Access Hospital (282NC0060X) |
United | 92986 | $7694.00 | 1518067586 - POMONA VALLEY HOSPITAL MEDICAL CENTER | 951115230 - (CA) POMONA VALLEY HOSPITAL MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | 92986 | $30091.00 | 1659330173 - MERCY MEDICAL CENTER | 111635088 - (NY) MERCY MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 92986 | $2391.51 | 1417177791 - OVERLOOK HOSPITAL | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Registered Dietitian (133V00000X) |
United | 92986 | $2973.00 | 1316180748 - MISSISSIPPI COUNTY HOSPITAL SYSTEM, GREAT RIVER MEDICAL CENTER | 716042625 - (AR) MISSISSIPPI COUNTY HOSPITAL SYSTEM | AR | 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 92986 vs. Other Cardiovascular Procedures Codes
The CPT 92986 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 92986 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92986. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92986 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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