CPT 92920: Percutaneous Transluminal Coronary Angioplasty, Single Major Coronary Artery
Medicare pays $388 and commercial payers pay $3530 on average nationally for this procedure.
CPT code 92920 describes a percutaneous transluminal coronary angioplasty procedure in which the provider inserts a balloon catheter through the skin and advances it into a major coronary artery or its branches, then inflates the balloon at the stenotic site to improve blood flow; this is an interventional cardiovascular percutaneous coronary angioplasty service typically performed in a cardiac catheterization laboratory or other inpatient/outpatient interventional cardiology setting.
For related coverage guidance, see recent payer policy updates: Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA), Cardiovascular Disease Risk Assessment, Biomarkers for Myocardial Infarction and Chronic Heart Failure.
Customize your policy alerts
Sign up for cpt 92920 policy alerts
Get alerted when payer policies referencing 92920 are released or updated.
Monitor payer policy activity
National Reimbursement Benchmarks
Medicare averages about $387.60 for CPT 92920, substantially lower than BUCA’s commercial mean of $3,530.50, highlighting a wide gulf between federal program reimbursement and commercial contracted averages. Blue Cross Blue Shield and BUCA show much higher central tendencies than Medicare and the other commercial payers, with BUCA’s mean emphasizing higher commercial market ceilings even though Medicare’s mean reflects more standardized, lower payments across 47 localities.
Dispersion (P75–P25) is smallest for Medicare at $30.00, indicating a tight distribution across localities. Among commercial payers, Cigna’s interquartile spread is $558.20 and UnitedHealth Group’s is $503.80, while Blue Cross Blue Shield displays the widest spread at $6,721.60, signaling substantial variability in negotiated rates. Aetna’s spread is $375.50 and BUCA’s is $3,049.00, placing payers along a clear continuum from tightly clustered Medicare rates to the highly dispersed BCBS outcomes.