CPT 93460 Fee Schedule

The fee schedules for CPT 93460 (Transcatheter placement of stent(s), pulmonary artery, initial vessel) are influenced by several key factors: 1. **Government Program Rates (Medicare & Medicaid):** These rates are largely set by federal and state governments. They are often fixed through complex reimbursement formulas and act as a baseline for many healthcare providers, especially for services provided to beneficiaries of these programs. 2. **Private Insurance Rates:** Fees for patients with private insurance are highly variable. These rates are typically negotiated directly between individual healthcare providers or health systems and specific private insurance companies, leading to a wide spectrum of pricing depending on the insurer, the specific plan, and the provider's contractual agreements. 3. **Geographic Location:** Healthcare costs can differ significantly based on the region. Areas with a higher cost of living, such as major metropolitan areas, generally have higher fee schedules to account for increased operational expenses like rent, salaries, and utilities. 4. **Provider Type and Facility:** The type of facility where the service is performed plays a crucial role. For instance, services performed in a hospital outpatient department may have different (often higher) facility fees compared to those performed in an an independent physician's office or an ambulatory surgical center, reflecting differences in overhead and resources. For specific information on CPT 93460 fee schedules relevant to your particular location and insurance plan, it is recommended to use Payerprice's fee schedule lookup tool. This tool allows you to search with the CPT code and your specific location to find relevant pricing information.