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See a sample rate comparisonCPT 92987 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 74 - Discontinued After Anesthesia 26 - Professional component |
| Complexity Level | High |
| Medicare Fee Schedule | $1,205.10 national non-facility rate (2026) · View Medicare rates for 92987 |
| Medicaid Fee Schedule | $944.395 median of the 8 states in the free preview · View Medicaid rates for 92987 |
National average reimbursement for CPT 92987 by major payers:
$1,785.28
$1,843.91
$1,807.48
$2,187.06
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CPT 92987
5 of 25 sample ratesHigher to lower in this preview
Dignity Health, Mercy Hospital Of Folsom
$27,444.00Published rateSeventh-Day Adventists Loma Linda University Medical Center, Loma Linda University Medical Center
Seventh-Day Adventists Loma Linda University Medical Center Inc
$16,561.00Published rateBridgport Hospital
Bridgeport Hospital
$12,309.00Published ratePorter
$3,582.00Published rateCarolina Radiology Associates LLC
Carolina Radiology Associates, LLC
$1,235.00Published rate
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See a sample payer proposalCPT 92987 vs. Other Cardiovascular Procedures Codes
The CPT 92987 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 92987 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. |
| 93010-CPT | Low | Heart Test Review And Report, Physician Evaluation And Documentation Of Electrocardiogram (Ecg Or Ekg) Test Results. The Test Is Used To Evaluate Heart Rate Rhythm And Conduction. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92987. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92987 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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