How much does Medicare pay for CPT 92943?

Medicare allowed an average of $618.11 per service and paid $490.74 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2494.16, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92943?

Removal of plaque, insertion of stent and/or balloon dilation of single coronary artery, branch or bypass graft. It was billed 2,069 times to 1,843 Medicare beneficiaries by 92 providers in 2024.

Which specialty bills 92943 most?

Interventional Cardiology, with 1,338 services from 59 clinicians. Next are Cardiology, Internal Medicine.

CPT 92943

Removal of plaque, insertion of stent and/or balloon dilation of single coronary artery, branch or bypass graft

$618.11Medicare-allowed amount per service, averaged across 2,069 services

Providers submitted

$2494.16

Asking price, not received

Medicare allowed

$618.11

The fee schedule figure

Medicare paid

$490.74

Balance is patient coinsurance

Providers submitted an average of $2494.16 for this code and Medicare allowed $618.11 — 4.0× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $490.74 (79%); the rest is the patient’s coinsurance and deductible.

Services: 2,069
Beneficiaries: 1,843
Providers billing it: 92
Total allowed: $1,278,870

What Medicare pays for CPT 92943

Across 2,069 services billed by 92 providers to 1,843 beneficiaries, Medicare allowed an average of $618.11 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 92943

Specialty	Services	Beneficiaries	Avg allowed	Providers
Interventional Cardiology	1,338	1,189	$619.41	59
Cardiology	646	579	$620.09	29
Internal Medicine	85	75	$582.49	4

92943 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	289	$636.96	$495.70	12
Washington	189	$649.38	$494.00	7
Massachusetts	166	$624.26	$482.57	6
Texas	161	$605.42	$496.69	7
New York	150	$727.27	$493.66	6
Indiana	104	$595.77	$491.07	3
Georgia	101	$622.67	$496.70	6
Michigan	80	$639.84	$477.41	2
Arizona	76	$579.76	$475.41	3
Tennessee	67	$473.21	$403.98	5
Ohio	66	$611.48	$498.08	4
Pennsylvania	63	$597.20	$502.52	3
Oregon	47	$592.97	$473.47	2
Minnesota	40	$552.96	$493.87	2
Missouri	39	$592.55	$478.04	1
Arkansas	37	$604.43	$502.12	2
Hawaii	35	$603.53	$494.14	1
Colorado	28	$547.01	$468.66	1
Iowa	28	$529.61	$475.52	1
District of Columbia	26	$694.73	$502.10	1
Maryland	23	$647.97	$491.01	1
Kansas	21	$538.05	$475.87	1
Oklahoma	20	$578.27	$486.96	1
Illinois	19	$691.21	$502.81	1
South Carolina	19	$571.72	$477.17	1
Mississippi	17	$537.86	$441.82	1
Alaska	17	$813.72	$475.62	1
New Jersey	16	$659.68	$485.37	1
Nebraska	16	$473.29	$497.59	1
New Hampshire	15	$504.10	$446.83	1
Virginia	15	$608.90	$502.58	1
Vermont	15	$589.91	$496.23	1
New Mexico	14	$612.86	$502.51	1
Kentucky	14	$587.58	$485.10	1
Florida	12	$657.83	$475.45	1
North Carolina	12	$536.05	$463.69	1
Louisiana	12	$644.40	$503.68	1

Related codes

92928Insertion of stents$525.63
92960External shock to heart to regulate heart beat$103.99
92978Ultrasound evaluation of heart blood vessel or graft$91.55
92979Ultrasound evaluation of heart blood vessel or graft$72.73
92972Shockwave destruction of calcified plaque in coronary artery accessed$141.81
92941Removal of plaque and blood clot$623.51
92933Removal of plaque$610.77
92920Balloon dilation of single coronary artery or branch$406.19
92950Manual attempt to restore blood circulation and breathing$178.69

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.