No office rate
92945 describes CTO revascularization using both antegrade and retrograde approaches; 92943 is for the antegrade approach.
On this page
CMS RVU26D · Effective 2026-10-01
92945 CTO revascularization Medicare reimbursement rates in Delaware
Reports coronary chronic total occlusion revascularization of one vessel when the interventional cardiologist uses both antegrade and retrograde approaches. Compare 92945 office and facility rates across CMS payment localities in Delaware.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 92945 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$629.67
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Cardiology
About 92945: Coronary chronic total occlusion revascularization, dual approach
Reports coronary chronic total occlusion revascularization of one vessel when the interventional cardiologist uses both antegrade and retrograde approaches.
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.
CMS billing rules for 92945
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.00 · 79%
- Practice expense (office) RVU2.84 · 15%
- Malpractice RVU1.08 · 6%
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.
92945 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
92941 applies to revascularization of a total coronary occlusion associated with acute myocardial infarction; 92945 is for a chronic total occlusion.
No office rate
Use 92937 when the treated target is a coronary bypass graft. Code 92945 applies to a native coronary vessel CTO treated with both approaches.
Compare 92945 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
Unavailable
Facility
$629.67
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 92945 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
11,912
- Code
- 92945
- Physician work
- 15.00
- Practice expense
- 2.84
- Malpractice
- 1.08
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.00 | × 1.005 | 15.0750 |
| Practice expense | 2.84 | × 0.988 | 2.8059 |
| Malpractice | 1.08 | × 0.899 | 0.9709 |
| Total RVUs | 18.8518 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$629.67
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15 | 1.005 |
| Practice expense | 2.84 | 0.988 |
| Malpractice | 1.08 | 0.899 |
(15 × 1.005 + 2.84 × 0.988 + 1.08 × 0.899) × $33.4009 = $629.67
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,90992937,,Prq trluml revsc cab grf 1,A,,11.02,2.07,NA,2.07,,2.59,15.68,15.68,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,91092941,,Prq trlml revsc tot occl ami,A,,12.40,2.35,NA,2.35,,2.90,17.65,17.65,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,91192943,,Prq trluml revsc ch occ ant,A,,13.35,2.51,NA,2.51,,3.12,18.98,18.98,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,91292945,,Prq trl rvs ch occ ant&rtrgr,A,,15.00,2.84,NA,2.84,,1.08,18.92,18.92,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,91392950,,Heart/lung resuscitation cpr,A,,3.90,7.01,,0.76,,0.44,11.35,5.10,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,91492953,,Temporary external pacing,A,,0.01,0.01,NA,0.01,,0.01,0.03,0.03,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,91592960,,Cardioversion electric ext,A,,1.95,2.53,,0.74,,0.15,4.63,2.84,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503