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 |
| Medicare Fee Schedule | View Medicare rates for 92990 |
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 | $10190.00 | 1760580757 - VCU HEALTH TAPPAHANNOCK HOSPITAL | 541489410 - (VA) VCU HEALTH TAPPAHANNOCK HOSPITAL | VA | Rural Acute Care Hospital (282NR1301X) |
United | 92990 | $8343.00 | 1023061496 - CRESTWOOD HEALTHCARE LP, CRESTWOOD MEDICAL CENTER | 621647983 | AL | 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 | $10639.00 | 1912527193 - ASCENSION NE WISCONSIN, INC, ASCENSION NE WISCONSIN-MERCY CAMPUS | 390816818 - ASCENSION NE WISCONSIN INC | WI | General Acute Care Hospital (282N00000X) |
United | 92990 | $8149.00 | 1538164090 - UNIVERSITY HEALTH SYSTEM, INC., UNIVERSITY OF TENNESSEE MEDICAL CENTER | 311626179 - (TN) UNIVERSITY HEALTH SYSTEMS INC | TN | General Acute Care Hospital (282N00000X) |
United | 92990 | $15089.98 | 1225450588 - PARISH HOSPITAL SERVICE DISTRICT FOR THE PARISH OF ORLEANS, NEW ORLEANS EAST HOSPITAL | 273335876 | LA | General Acute Care Hospital (282N00000X) |
United | 92990 | $16286.00 | 1720185267 - PHELPS MEMORIAL HOSPITAL ASSOCIATION, PHELPS HOSPITAL | 131725076 - (NY) PHELPS MEMORIAL HOSPITAL ASSOCIATION | NY | General Acute Care Hospital (282N00000X) |
United | 92990 | $5655.00 | 1154361475 - SJ MEDICAL CENTER, LLC, ST. JOSEPH MEDICAL CENTER | 204835578 - (TX) SJ MEDICAL CENTER, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 92990 | $13730.00 | 1750661534 - AHS SOUTHCREST HOSPITAL, LLC., HILLCREST HOSPITAL SOUTH | 452711804 | OK | General Acute Care Hospital (282N00000X) |
United | 92990 | $7691.00 | 1699819003 - TAKOMA REGIONAL HOSPITAL INC, BALLAD HEALTH MEDICAL ASSOCIATES | 510603966 - TAKOMA REGIONAL HOSPITAL INC | TN | General Acute Care Hospital (282N00000X) |
United | 92990 | $2252.00 | 1831183748 - HOMER MEMORIAL HOSPITAL, CLAIBORNE MEMORIAL MEDICAL CENTER | 720396868 - (LA) HOMER MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 92990 | $8286.00 | 1578529285 - VALLEY PRESBYTERIAN HOSPITAL | 951945832 - (CA) VALLEY PRESBYTERIAN HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 92990 | $8367.00 | 1841258589 - CRIPPLED CHILDREN'S HOSPITAL, CHILDREN'S HOSPITAL | 540506309 - (VA) VCU HEALTH CHILDRENS SERVICES AT BROOK ROAD | VA | Children's Hospital (282NC2000X) |
United | 92990 | $5327.00 | 1447352323 - ST JOSEPHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F, HSHS ST. JOSEPH'S HOSPITAL -HIGHLAND | 370663568 - (IL) ST JOSEPHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THRID ORDER OF ST F | IL | Critical Access Hospital (282NC0060X) |
United | 92990 | $5474.00 | 1265465439 - ADVENTIST MIDWEST HEALTH, UCHICAGO MEDICINE ADVENTHEALTH HINSDALE | 362276984 - ADVENTIST MIDWEST HEALTH | IL | 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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