Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 92986 Fee Schedule
Last Verified: October 2026
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.
Surgery On Blocked Heart Valve, Procedure To Insert A Small Tube Through The Skin To One Of Three Valves On The Left Side Of The Heart (Aortic Mitral Or Valve To Lung). A Balloon At The End Of The Tube Is Inflated To Open A Blocked Valve.
| 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 | GC - Service performed by resident under supervision 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | $1,168.03 national non-facility rate (2026) · View Medicare rates for 92986 |
| Medicaid Fee Schedule | $914.97 median of the 8 states in the free preview · View Medicaid rates for 92986 |
National average reimbursement for CPT 92986 by major payers:
$1,675.81
$1,786.64
$1,833.96
$2,118.62
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 92986.
CPT 92986
5 of 25 sample ratesHigher to lower in this preview
Mercy Medical Center
$30,091.00Published rateBaycare Aurora, LLC, Aurora Baycare Medical Center
$13,851.00Published rateMemorial Hospital Of Texas County Authority
$8,707.00Published rateOverlook Hospital
Atlantic Health System Inc
$2,391.51Published rateUniversity Imaging Center, Charles E Buckley, Md, PA
University Imaging Center Charles E Buckley Md PA
$778.71Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 92986-CPT | High | Surgery On Blocked Heart Valve, Procedure To Insert A Small Tube Through The Skin To One Of Three Valves On The Left Side Of The Heart (Aortic Mitral Or Valve To Lung). A Balloon At The End Of The Tube Is Inflated To Open A Blocked Valve. |
| 92987-CPT | High | Surgery On Blocked Heart Valve, Procedure To Insert A Small Tube Through The Skin To One Of Three Valves On The Left Side Of The Heart (Aortic Mitral Or Valve To Lung). A Balloon At The End Of The Tube Is Inflated To Open A Blocked Valve. |
| 92990-CPT | High | Surgery On Blocked Heart Valve, Procedure To Insert A Small Tube Through The Skin To One Of Three Valves On The Left Side Of The Heart (Aortic Mitral Or Valve To Lung). A Balloon At The End Of The Tube Is Inflated To Open A Blocked Valve. |
| 93000-CPT | Low | Electrocardiogram Routine Ecg, Electrocardiogram Routine Ecg With At Least 12 Leads With Interpretation And Report Electrocardiogram Routine Ecg With At Least 12 Leads With |
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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 92986) and we'll show you how you compare in 15 minutes or less.