CPT code 92945: CTO revascularization, antegrade and retrograde2026 Medicare rate & RVUs in Puerto Rico
Reports coronary chronic total occlusion revascularization of one vessel when the interventional cardiologist uses both antegrade and retrograde approaches.
In Puerto Rico, Medicare pays $632.45 for 92945 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 92945 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 92945 covers
An interventional cardiologist reports this service when reopening a chronic total occlusion in one coronary vessel requires both antegrade and retrograde crossing approaches. The work takes place during a catheter-based coronary intervention, typically in a hospital catheterization laboratory. The two approaches describe how the operator reaches and crosses the occlusion; they do not represent treatment of two separate vessels.
The record should identify the target vessel, establish that the occlusion is chronic, and support use of both crossing approaches. Report the code once for the treated vessel; ordinary balloon or stent treatment in that same vessel is part of the revascularization service when performed. The procedure has a 0-day global period, so same-day preoperative and postoperative care are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Puerto Rico compares for 92945
Across 109 of 109 payment localities, the facility rate for 92945 runs from $601.07 in Arkansas to $872.42 in Alaska. Puerto Rico pays $632.45. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$632.45
- Los Angeles, CA · California$657.73+$25.28
- Washington, DC area · District of Columbia$679.96+$47.51
- Miami, FL · Florida$690.99+$58.54
- Chicago, IL · Illinois$682.64+$50.19
- Manhattan, NY · New York$700.52+$68.07
- Alaska · Alaska$872.42+$239.97
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $604.43 |
| ArkansasArkansas | — | $601.07 |
| ArizonaArizona | — | $623.81 |
| Bakersfield, CACalifornia | — | $636.47 |
| Chico, CACalifornia | — | $632.83 |
| El Centro, CACalifornia | — | $633.01 |
| Fresno, CACalifornia | — | $632.83 |
| Hanford, CACalifornia | — | $632.83 |
| Madera, CACalifornia | — | $632.83 |
| Merced, CACalifornia | — | $632.83 |
| Modesto, CACalifornia | — | $632.83 |
| Napa, CACalifornia | — | $675.93 |
| Oxnard, CACalifornia | — | $649.64 |
| Redding, CACalifornia | — | $632.83 |
| Rest of CaliforniaCalifornia | — | $632.83 |
| Riverside, CACalifornia | — | $644.77 |
| Sacramento, CACalifornia | — | $648.71 |
| Salinas, CACalifornia | — | $645.82 |
| San Diego, CACalifornia | — | $649.05 |
| Marin County, CACalifornia | — | $698.92 |
| San Francisco, CACalifornia | — | $697.69 |
| San Benito County, CACalifornia | — | $712.25 |
| Santa Clara County, CACalifornia | — | $707.23 |
| San Luis Obispo, CACalifornia | — | $636.91 |
| Santa Cruz, CACalifornia | — | $646.12 |
| Santa Maria, CACalifornia | — | $644.98 |
| Santa Rosa, CACalifornia | — | $651.87 |
| Stockton, CACalifornia | — | $632.83 |
| Vallejo, CACalifornia | — | $674.16 |
| Visalia, CACalifornia | — | $632.83 |
| Yuba City, CACalifornia | — | $632.83 |
| ColoradoColorado | — | $636.13 |
| ConnecticutConnecticut | — | $656.84 |
| DelawareDelaware | — | $629.67 |
| Fort Lauderdale, FLFlorida | — | $662.33 |
| Rest of FloridaFlorida | — | $645.92 |
| Atlanta, GAGeorgia | — | $642.22 |
| Rest of GeorgiaGeorgia | — | $628.63 |
| Hawaii, Guam, HIHawaii | — | $629.75 |
| IowaIowa | — | $602.13 |
| IdahoIdaho | — | $605.35 |
| East St. Louis, ILIllinois | — | $660.93 |
| Rest of IllinoisIllinois | — | $644.00 |
| Suburban Chicago, ILIllinois | — | $665.86 |
| IndianaIndiana | — | $606.48 |
| KansasKansas | — | $604.95 |
| KentuckyKentucky | — | $618.35 |
| New Orleans, LALouisiana | — | $631.25 |
| Rest of LouisianaLouisiana | — | $619.52 |
| Metropolitan Boston, MAMassachusetts | — | $666.92 |
| Rest of MassachusettsMassachusetts | — | $637.67 |
| Baltimore area, MDMaryland | — | $655.44 |
| Rest of MarylandMaryland | — | $635.14 |
| Rest of MaineMaine | — | $610.72 |
| Southern Maine, MEMaine | — | $617.78 |
| Detroit, MIMichigan | — | $653.37 |
| Rest of MichiganMichigan | — | $628.35 |
| MinnesotaMinnesota | — | $609.30 |
| Metropolitan Kansas City, MOMissouri | — | $625.33 |
| Metropolitan St. Louis, MOMissouri | — | $627.46 |
| Rest of MissouriMissouri | — | $617.92 |
| MississippiMississippi | — | $609.34 |
| MontanaMontana | — | $631.87 |
| North CarolinaNorth Carolina | — | $612.57 |
| North DakotaNorth Dakota | — | $610.52 |
| NebraskaNebraska | — | $602.20 |
| New HampshireNew Hampshire | — | $631.33 |
| Northern New JerseyNew Jersey | — | $681.14 |
| Rest of New JerseyNew Jersey | — | $664.21 |
| New MexicoNew Mexico | — | $631.32 |
| NevadaNevada | — | $626.02 |
| NYC suburbs and Long Island, NYNew York | — | $712.85 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $671.08 |
| Queens, NYNew York | — | $697.22 |
| Rest of New YorkNew York | — | $616.49 |
| OhioOhio | — | $623.98 |
| OklahomaOklahoma | — | $613.75 |
| Portland, OROregon | — | $641.26 |
| Rest of OregonOregon | — | $620.85 |
| Metropolitan Philadelphia, PAPennsylvania | — | $651.81 |
| Rest of PennsylvaniaPennsylvania | — | $622.18 |
| Rhode IslandRhode Island | — | $640.70 |
| South CarolinaSouth Carolina | — | $619.32 |
| South DakotaSouth Dakota | — | $607.99 |
| TennesseeTennessee | — | $606.61 |
| Austin, TXTexas | — | $634.34 |
| Beaumont, TXTexas | — | $620.85 |
| Brazoria, TXTexas | — | $627.16 |
| Dallas, TXTexas | — | $630.95 |
| Fort Worth, TXTexas | — | $630.47 |
| Galveston, TXTexas | — | $629.08 |
| Houston, TXTexas | — | $648.85 |
| Rest of TexasTexas | — | $623.61 |
| UtahUtah | — | $622.57 |
| VirginiaVirginia | — | $619.73 |
| Virgin Islands, VIUnited States Virgin Islands | — | $632.45 |
| VermontVermont | — | $613.18 |
| Rest of WashingtonWashington | — | $634.86 |
| King County, WAWashington | — | $671.93 |
| WisconsinWisconsin | — | $603.00 |
| West VirginiaWest Virginia | — | $635.07 |
| WyomingWyoming | — | $622.57 |
92945 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 92945 rate is calculated
Each of 92945’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 92945
RVUs × geographic indexes × conversion factor
Work15.00
15.00 RVUs× 1.000 GPCI
Practice expense2.84
2.84 RVUs× 1.000 GPCI
Malpractice1.08
1.08 RVUs× 1.000 GPCI
Adjusted RVUs
18.9200
Conversion factor
$33.4009
Medicare rate
$631.95
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,912
- Code
- 92945
- Physician work
- 15.00
- Practice expense
- 2.84
- Malpractice
- 1.08
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.00 | × 1.000 | 15.0000 |
| Practice expense | 2.84 | × 1.011 | 2.8712 |
| Malpractice | 1.08 | × 0.985 | 1.0638 |
| Total RVUs | 18.9350 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Puerto Rico$632.45
Facility: (15 × 1 + 2.84 × 1.011 + 1.08 × 0.985) × $33.4009 = $632.45
Payment rules and modifiers for 92945
The CMS indicators that decide how 92945 is paid alongside other services.
CMS payment indicators · 92945
CTO revascularization, antegrade and retrograde
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
92945 without 51 · national facility
$631.95
CTO revascularization, antegrade and retrograde
92945-51 · Second procedure: 50%
$315.98
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 92945 has changed in Puerto Rico
92945 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
No ratechanged toNo rate
Held through RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $632.45 | RVU26D |
| 2026-07-01 | Not available in this setting | $632.45 | RVU26C |
| 2026-04-01 | Not available in this setting | $632.45 | RVU26B |
| 2026-01-01 | Not available in this setting | $632.45 | RVU26A |
| 2025-10-01 | Not in this release | Not in this release | RVU25D |
| 2025-07-01 | Not in this release | Not in this release | RVU25C |
| 2025-04-01 | Not in this release | Not in this release | RVU25B |
| 2025-01-01 | Not in this release | Not in this release | RVU25A |
| 2024-10-01 | Not in this release | Not in this release | RVU24D |
| 2024-07-01 | Not in this release | Not in this release | RVU24C |
| 2024-04-01 | Not in this release | Not in this release | RVU24B |
| 2024-03-09 | Not in this release | Not in this release | RVU24AR |
| 2024-01-01 | Not in this release | Not in this release | RVU24A |
| 2023-10-01 | Not in this release | Not in this release | RVU23D |
| 2023-07-01 | Not in this release | Not in this release | RVU23C |
| 2023-04-01 | Not in this release | Not in this release | RVU23B |
| 2023-01-01 | Not in this release | Not in this release | RVU23A |
| 2022-10-01 | Not in this release | Not in this release | RVU22D |
| 2022-07-01 | Not in this release | Not in this release | RVU22C |
| 2022-04-01 | Not in this release | Not in this release | RVU22B |
| 2022-01-01 | Not in this release | Not in this release | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
92945 billing questions
How does this differ from 92943?
Use 92945 when both antegrade and retrograde approaches are used to revascularize the chronic total occlusion. Code 92943 describes CTO revascularization using the antegrade approach.
Can balloon angioplasty or stenting in the same vessel be billed separately?
No. Balloon or stent treatment performed as part of revascularizing the same CTO vessel is included in this service.
What documentation supports reporting 92945?
Document the chronic total occlusion, the target coronary vessel, and the use of both antegrade and retrograde approaches to cross and treat it.
Can modifier 50 be used when more than one coronary vessel is treated?
No. Modifier 50 is inappropriate for this code. Report applicable services by treated vessel and apply the same-session multiple procedure reduction when required.
When is assistant-at-surgery payment allowed?
CMS pays an assistant at surgery only when the medical necessity of the assistant is documented.
Can co-surgeons or a surgical team report this service?
Co-surgeon and team-surgery payment are not permitted for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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