CPT 92990 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 • 63 • GC - Service performed by resident under supervision |
| Complexity Level | High |
National average reimbursement for CPT 92990 by major payers:
$1,415.94
$1,455.97
$1,489.36
$1,745.39
| 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 92990 | ||||||
United | 92990 | $1076.32 | 1457345910 - BRADLEY SMITH | 561079264 - EMERGEORTHO, P.A. | NC | Orthopaedic Surgery Physician (207X00000X) |
United | 92990 | $27603.00 | 1821244757 - JOHN T MATHER MEMORIAL HOSPITAL, INTENSIVISTS | 111639818 - (NY) JOHN T MATHER MEMORIAL HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 92990 | $4221.00 | 1609860659 - FORT LOUDOUN MEDICAL CENTER | 621373691 - (TN) FORT LOUDOUN MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | 92990 | $14069.00 | 1528519014 - THE MOUNT SINAI HOSPITAL | 131624096 - MOUNT SINAI HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 92990 | $18897.00 | 1447406699 - FRANCISCAN HEALTH SYSTEM, ST ANTHONY HOSPITAL | 383769889 | WA | General Acute Care Hospital (282N00000X) |
United | 92990 | $3077.00 | 1568481984 - MERCY HOSPITAL SOUTH | 430980256 - (MO) MERCY HOSPITAL SOUTH | MO | General Acute Care Hospital (282N00000X) |
United | 92990 | $1553.00 | 1982641593 - GEORGE COUNTY HOSPITAL- CRNA | 646001398 | MS | Rural Acute Care Hospital (282NR1301X) |
United | 92990 | $18974.00 | 1801128921 - LONG ISLAND JEWISH MEDICAL CENTER | 112241326 - LONG ISLAND JEWISH MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 92990 | $10202.00 | 1225128432 - UNIVERSITY HOSPITALS GENEVA MEDICAL CENTER, THE MEMORIAL HOSPITAL OF GENEVA | 340714461 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | Critical Access Hospital (282NC0060X) |
United | 92990 | $11664.00 | 1497859789 - MOUNTAIN STATES HEALTH ALLIANCE, JOHNSON COUNTY COMMUNITY HOSPITAL | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | TN | Critical Access Hospital (282NC0060X) |
United | 92990 | $14601.00 | 1902832306 - THEDACARE REGIONAL MEDICAL CENTER, APPLETON MEDICAL CENTER,INC. | 350983617 - COMMUNITY HEALTH NETWORK INC | WI | General Acute Care Hospital (282N00000X) |
United | 92990 | $3183.00 | 1306909734 - INDEPENDENT HEALTHCARE MANAGEMENT, INC., S E LACKEY MEMORIAL HOSPITAL | 640770155 - INDEPENDENT HEALTHCARE MANAGEMENT INC | MS | Critical Access Hospital (282NC0060X) |
United | 92990 | $51762.50 | 1437605532 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CENTER FOR PEDIATRIC MED | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 92990 | $9386.00 | 1285253252 - OCHSNER LSU HEALTH SHREVEPORT, OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER | 850672191 - (LA) OCHSNER LSU HEALTH SHREVEPORT | LA | Women's Hospital (282NW0100X) |
United | 92990 | $18756.00 | 1548291883 - TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN | 752890358 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN | 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 92990 vs. Other Cardiovascular Procedures Codes
The CPT 92990 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 92990 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 | Perc Balloon Vulvoplasty; Aortic Valve |
| 92987-CPT | High | Percutaneous Balloon Valvuloplasty; Mitral Valve |
| 92990-CPT | High | Perc Balloon Vulvoplasty; Pulmonary |
| 93005-CPT | Low | Electrocardiogram, Routine Ecg With At Least 12 Leads; Tracing Only, Without Interpretation And Report |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92990. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92990 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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