CPT 92998 Fee Schedule
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.
| 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 | • None • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 92998 by major payers:
$413.10
$433.71
$439.11
$511.93
| 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 92998 | ||||||
United | 92998 | $8215.00 | 1184262800 - SANA HEALTHCARE CARROLLTON | 843683956 - (TX) SANA HEALTHCARE DBA CARROLLTON REGIONAL MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 92998 | $1899.00 | 1851370910 - TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA | 231352685 - TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA | PA | General Acute Care Hospital (282N00000X) |
United | 92998 | $10336.00 | 1093975377 - BRISTOL HOSPITAL INC | 60646559 - (CT) BRISTOL HOSPITAL INCORPORATED | CT | General Acute Care Hospital (282N00000X) |
United | 92998 | $12566.66 | 1265698948 - UNIVERSITY OF IOWA HOSPITAL AND CLINICS | 426004813 | IA | General Acute Care Hospital (282N00000X) |
United | 92998 | $3455.00 | 1043526023 - WARREN OHIO HOSPITAL COMPANY LLC, TRUMBULL MEMORIAL HOSPITAL | 815457243 | OH | General Acute Care Hospital (282N00000X) |
United | 92998 | $9904.00 | 1235940909 - TENOR HEALTH FOUNDATION SHARON, LLC | 332621724 | PA | General Acute Care Hospital (282N00000X) |
United | 92998 | $11377.00 | 1598282246 - SEBRING HEALTH SERVICES, LLC, HCA FLORIDA HIGHLANDS HOSPITAL | 822084329 | FL | General Acute Care Hospital (282N00000X) |
United | 92998 | $9996.00 | 1598864118 - NYU HOSPITALS CENTER | 133971298 - NYU LANGONE HOSPITALS | NY | General Acute Care Hospital (282N00000X) |
United | 92998 | $1679.00 | 1134126659 - CALDWELL MEMORIAL HOSPITAL INC | 720878037 - (LA) CALDWELL MEMORIAL HOSPITAL INC | LA | General Acute Care Hospital (282N00000X) |
United | 92998 | $14507.00 | 1386651297 - PORTERCARE ADVENTIST HEALTH SYSTEM, ADVENTHEALTH PARKER | 840438224 - PORTERCARE ADVENTIST HEALTH SYSTEM | CO | General Acute Care Hospital (282N00000X) |
United | 92998 | $12330.00 | 1114023512 - DEACONESS WOMEN'S HOSPITAL OF SOUTHERN INDIANA, LLC, THE WOMEN'S HOSPITAL | 352062016 - (IN) DEACONESS WOMENS HOSPITAL OF SOUTHERN INDIANA, LLC | IN | General Acute Care Hospital (282N00000X) |
United | 92998 | $9805.00 | 1740233782 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN MEMORIAL CITY HOSPITAL | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | General Acute Care Hospital (282N00000X) |
United | 92998 | $10660.00 | 1306355680 - PIEDMONT ROCKDALE HOSPITAL INC. | 300999841 - (GA) PIEDMONT ROCKDALE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 92998 | $5928.00 | 1205904885 - JEFFERSON HEALTH, ARIA HEALTH BUCKS COUNTY CAMPUS | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | General Acute Care Hospital (282N00000X) |
United | 92998 | $9178.00 | 1710097936 - OCHSNER MEDICAL CENTER | 205432782 | LA | 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 92998 vs. Other Cardiovascular Procedures Codes
The CPT 92998 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 92998 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 | Percutaneous Transluminal Pulmonary Artery Balloon Angioplasty; Single |
| 92998-CPT | Moderate | Percutaneous Transluminal Pulmonary Artery Balloon Angioplasty; Each Additional Vessel (List Separately In Addition To Code For Primary Procedure) |
| 93005-CPT | Low | Electrocardiogram, Routine Ecg With At Least 12 Leads; Tracing Only, Without Interpretation And Report |
| 93010-CPT | Low | Ecg;Interpretation & Report Only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92998. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92998 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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