Billing code 92945: CTO revascularizationMedicare rate & RVUs in Guam
Reports coronary chronic total occlusion revascularization of one vessel when the interventional cardiologist uses both antegrade and retrograde approaches.
CMS doesn’t publish an office rate for 92945 in Guam.
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 9 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.
92945 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $629.75 |
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.
Payment rules and modifiers for 92945
The CMS indicators that decide how 92945 is paid alongside other services.
CMS payment indicators · 92945
CTO revascularization
| 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
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%).
92945 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92943CTO PCI
- 92945 describes CTO revascularization using both antegrade and retrograde approaches; 92943 is for the antegrade approach.
- 92941Coronary revascularization
- 92941 applies to revascularization of a total coronary occlusion associated with acute myocardial infarction; 92945 is for a chronic total occlusion.
- 92937Graft revascularization
- Use 92937 when the treated target is a coronary bypass graft. Code 92945 applies to a native coronary vessel CTO treated with both approaches.
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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