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Billing code 92997: Pulmonary angioplastyMedicare rate & RVUs

Percutaneous balloon angioplasty opens a narrowed pulmonary artery vessel, typically during catheter-based treatment of congenital or acquired pulmonary artery stenosis.

CMS RVU26DEffective Oct 1, 2026109 payment localities406 Medicare services in 2024

Medicare pays $547.44 for 92997 nationally in a facility.

Medicare rate · 92997

Pulmonary angioplasty

Swap in your local Medicare rate.

Work RVUs
11.68
Total RVUs
16.39
Global days
000

National rate · 2026

$547.44

Facility setting, before claim adjustments.

See every locality for 92997 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 92997 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 92997 covers

This code represents catheter-based balloon dilation of one pulmonary artery vessel to improve blood flow through a narrowed segment. Interventional cardiologists, including specialists in congenital heart disease, typically perform it in a hospital catheterization laboratory. The target is a pulmonary artery, not the pulmonary valve or a coronary artery. The service may be part of a catheter-based intervention for pulmonary artery stenosis, including stenosis associated with congenital heart disease.

Report one unit for the treated vessel; the operative report should identify the pulmonary artery treated and document the balloon dilation. For each additional pulmonary artery vessel treated, report add-on code 92998 with this primary service. Modifier 50 is inappropriate; code the vessels treated rather than treating the service as bilateral. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery 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.

Where 92997 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

92997 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$503.52
Alaska*Unavailable$712.38
ArizonaUnavailable$533.69
ArkansasUnavailable$498.26
AtlantaUnavailable$565.65
AustinUnavailable$543.84
BakersfieldUnavailable$531.73
Baltimore/Surr. CntysUnavailable$578.04
BeaumontUnavailable$534.77
BrazoriaUnavailable$532.58

92997 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
92997 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 92997 rate is calculated

Each of 92997’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 · 92997

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.68Practice expense 2.36Malpractice 2.35

16.3900 adjusted RVUs×$33.4009 conversion factor=$547.44

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 92997

The CMS indicators that decide how 92997 is paid alongside other services.

CMS payment indicators · 92997

Pulmonary angioplasty

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

92997 without 51 · national facility

$547.44

Pulmonary angioplasty

92997-51 · Second procedure: 50%

$273.72

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%).

When to use modifier 51

92997 compared with similar codes

Compare codes

92997 vs 92998 vs 92990 vs 92920: national Medicare rates

Swap in your local Medicare rate.

  • 92997
    Pulmonary angioplasty · 11.68 wRVU
    —
  • 92998
    Pulmonary angioplasty · 5.84 wRVU
    —
  • 92990
    Valve dilation · 17.81 wRVU
    —
  • 92920
    Coronary angioplasty · 8.14 wRVU
    —

How to choose

92998Pulmonary angioplasty
92997 covers the first pulmonary artery vessel treated; 92998 is reported for each additional vessel.
92990Valve dilation
92990 treats stenosis at the pulmonary valve. Use 92997 when the balloon dilation targets a pulmonary artery vessel.
92920Coronary angioplasty
92920 describes coronary artery balloon angioplasty. This code is for balloon dilation of a pulmonary artery vessel.

Codes related to 92997

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 92997
CodeHow it relatesNational office range
Add-on codes
92998Pulmonary angioplastyAdd-on service for each additional pulmonary artery vessel treated.No office rate
Used instead
92990Valve dilationPulmonary valve balloon treatment; use when the target is the valve rather than an artery.No office rate
92920Coronary angioplastyBalloon angioplasty code for a coronary artery, not a pulmonary artery.No office rate

92997 billing questions

When should 92997 be reported instead of 92998?

Report 92997 for balloon angioplasty of one pulmonary artery vessel. Report 92998 for each additional vessel treated in the same session, with 92997 as the primary service.

Is the code based on the number of lesions or vessels?

The distinction is the number of pulmonary artery vessels treated. Document the vessel or vessels and the balloon dilation performed.

Can modifier 50 be used when both sides are treated?

No. Modifier 50 is inappropriate for this code; report the applicable vessel services, including 92998 for each additional vessel.

What care is included in the global period?

The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

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
RVUs for 92997PPRRVU2026_Oct_nonQPP.csv, line 11,931 (RVU26D)

Open CMS sourceHow we calculate rates

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