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See a sample rate comparisonCPT 92997 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Angioplasty To Widen Artery, This Procedure Inserts A Small Tube Into The Artery From The Heart To The Lung. A Balloon Is Inflated To Open And Enlarge The Artery.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Cardiovascular Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | GC - Service performed by resident under supervision 82 - Assistant surgeon - no qualified resident |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $547.44 national non-facility rate (2026) · View Medicare rates for 92997 |
| Medicaid Fee Schedule | $481.25 median of the 8 states in the free preview · View Medicaid rates for 92997 |
National average reimbursement for CPT 92997 by major payers:
$802.09
$864.63
$913.57
$1,025.74
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CPT 92997
5 of 25 sample ratesHigher to lower in this preview
John Muir Health, John Muir Health, Walnut Creek Medical Center
John Muir Health
$48,622.00Published rateMartin Health, West Tennessee Healthcare Volunteer Hospital
Martin Health
$8,799.00Published rateNorth Carolina Specialty Hospital LLC
$5,322.00Published rateLahaye Center For Advanced Eye Care, Apmc, Lahaye Eye Clinic
Lahaye Eye Clinic, P.C.
$2,441.00Published rateCarolina Radiology Associates LLC
Carolina Radiology Associates, LLC
$568.11Published rate
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See a sample payer proposalCPT 92997 vs. Other Cardiovascular Procedures Codes
The CPT 92997 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 92997 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 |
|---|---|---|
| 92997-CPT | Moderate | Angioplasty To Widen Artery, This Procedure Inserts A Small Tube Into The Artery From The Heart To The Lung. A Balloon Is Inflated To Open And Enlarge The Artery. |
| 92998-CPT | Moderate | Percutaneous Transluminal Pulm, Percutaneous Transluminal Pulmonary Artery Balloonangioplasty Each Additional Vessel (List Separately In Addition To Code For Primary Procedure) |
| 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 |
| 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 92997. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92997 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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