How much does Medicare pay for CPT 92960?

Medicare allowed an average of $103.99 per service and paid $80.37 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $612.74, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92960?

External shock to heart to regulate heart beat. It was billed 146,028 times to 134,204 Medicare beneficiaries by 5,786 providers in 2024.

Does 92960 pay differently in an office than a hospital?

Yes. The allowed amount averaged $143.51 in an office setting and $103.68 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 92960 most?

Cardiology, with 76,798 services from 3,400 clinicians. Next are Clinical Cardiac Electrophysiology, Interventional Cardiology, Internal Medicine.

CPT 92960

External shock to heart to regulate heart beat

$103.99Medicare-allowed amount per service, averaged across 146,028 services

Providers submitted

$612.74

Asking price, not received

Medicare allowed

$103.99

The fee schedule figure

Medicare paid

$80.37

Balance is patient coinsurance

Providers submitted an average of $612.74 for this code and Medicare allowed $103.99 — 5.9× 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 $80.37 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $143.51
Hospital / facility: $103.68

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,159 services were billed in an office setting and 144,869 in a facility.

Services: 146,028
Beneficiaries: 134,204
Providers billing it: 5,786
Total allowed: $15,185,452

What Medicare pays for CPT 92960

Across 146,028 services billed by 5,786 providers to 134,204 beneficiaries, Medicare allowed an average of $103.99 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 92960

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	76,798	71,455	$104.27	3,400
Clinical Cardiac Electrophysiology	42,894	38,166	$105.72	1,253
Interventional Cardiology	11,684	10,815	$102.77	585
Internal Medicine	5,916	5,502	$103.29	235
Nurse Practitioner	3,887	3,650	$90.38	109
Physician Assistant	2,086	1,989	$91.01	71
Advanced Heart Failure and Transplant Cardiology	1,004	975	$105.51	46
Emergency Medicine	798	757	$101.92	44
Cardiac Surgery	191	174	$107.44	8
Nuclear Medicine	152	144	$107.87	7
Adult Congenital Heart Disease	85	83	$108.51	3
Hospitalist	82	79	$102.81	4
Sleep Medicine	69	64	$105.57	3
Critical Care (Intensivists)	61	55	$100.03	2
Interventional Radiology	52	43	$98.05	2

92960 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
Florida	10,470	$106.02	$81.32	413
California	9,406	$111.34	$80.29	394
Ohio	8,528	$101.12	$79.39	289
Texas	7,857	$103.18	$81.10	341
Pennsylvania	7,776	$103.87	$79.95	343
New York	7,546	$115.80	$80.93	234
Illinois	6,206	$106.45	$79.51	229
Virginia	5,590	$104.54	$79.99	213
North Carolina	5,426	$99.11	$79.08	215
Massachusetts	5,407	$107.53	$78.79	199
Tennessee	4,571	$98.95	$80.54	174
South Carolina	4,066	$99.66	$79.94	142
Georgia	4,062	$102.46	$79.06	178
Indiana	4,030	$98.36	$79.98	166
Missouri	3,736	$101.62	$80.63	156
Michigan	3,690	$102.60	$77.88	167
New Jersey	3,202	$112.42	$81.02	139
Washington	2,815	$107.18	$79.50	133
Maryland	2,750	$108.98	$79.75	112
Arizona	2,727	$103.13	$80.52	117
Alabama	2,676	$98.00	$79.76	102
Wisconsin	2,425	$99.52	$79.07	104
Kansas	2,273	$98.62	$81.38	84
Iowa	2,204	$97.56	$80.29	74
Oklahoma	2,103	$98.98	$80.65	67
Minnesota	2,078	$95.52	$74.12	80
Arkansas	2,068	$97.91	$80.98	64
Kentucky	2,013	$101.42	$79.24	95
Nebraska	1,773	$97.23	$80.06	64
Mississippi	1,752	$99.22	$80.16	70
Louisiana	1,615	$100.53	$80.57	63
New Hampshire	1,422	$105.18	$80.95	56
Colorado	1,404	$104.49	$78.09	73
Utah	1,286	$97.22	$76.20	44
Oregon	1,201	$103.63	$78.37	61
Connecticut	1,131	$106.23	$77.32	48
Nevada	766	$103.91	$80.53	38
Idaho	749	$98.64	$79.67	29
Delaware	680	$103.82	$80.67	26
South Dakota	664	$98.35	$76.36	23
West Virginia	575	$102.69	$80.88	21
Montana	466	$104.38	$78.05	17
North Dakota	420	$101.49	$81.36	15
Alaska	406	$136.92	$80.10	19
Vermont	392	$101.14	$79.44	13
Maine	366	$103.50	$81.09	24
Rhode Island	353	$106.27	$78.95	17
District of Columbia	298	$112.98	$79.15	14
New Mexico	271	$92.09	$71.81	10
Wyoming	220	$116.24	$89.05	11
Hawaii	69	$105.79	$81.82	4
Puerto Rico	25	$104.16	$82.77	1
Guam	23	$170.25	$117.44	1

Related codes

92928Insertion of stents$525.63
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
92943Removal of plaque$618.11
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.