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See a sample rate comparisonCPT 92990 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 | 63 GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $965.95 national non-facility rate (2026) · View Medicare rates for 92990 |
| Medicaid Fee Schedule | $756.41 median of the 8 states in the free preview · View Medicaid rates for 92990 |
National average reimbursement for CPT 92990 by major payers:
$1,415.94
$1,455.97
$1,489.36
$1,734.77
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CPT 92990
5 of 25 sample ratesHigher to lower in this preview
John T Mather Memorial Hospital, Intensivists
John T Mather Memorial Hospital
$27,603.00Published rateAhs Southcrest Hospital, LLC., Hillcrest Hospital South
$13,730.00Published rateChippenham & Johnston-Willis Hospitals, Inc., Cjw Medical Center
$9,389.00Published rateSt. John Broken Arrow, Inc, St. John Broken Arrow
St John Broken Arrow Inc
$7,708.00Published rateHomer Memorial Hospital, Claiborne Memorial Medical Center
Homer Memorial Hospital
$2,252.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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 | 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. |
| 93005-CPT | Low | Electrocardiogram Routine Ecg, Electrocardiogram Routine Ecg With At Least 12 Leadstracing Only Without Interpretation And Report Electrocardiogram Routine Ecg With At Least 12leads |
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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