No office rate
This code describes antegrade CTO treatment. Use 92945 when the procedure uses both antegrade and retrograde approaches.
On this page
CMS RVU26D · Effective 2026-10-01
92943 CTO PCI Medicare reimbursement rates in Missouri
Reports antegrade percutaneous treatment of a chronic total occlusion in one coronary vessel, including the revascularization methods used in that vessel. Compare 92943 office and facility rates across CMS payment localities in Missouri.
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 92943 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$619.67–$630.13
3 of 3 localities have a supported rate.
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.
Where 92943 pays more and less in Missouri
Interventional cardiology
About 92943: Antegrade chronic total occlusion PCI
Reports antegrade percutaneous treatment of a chronic total occlusion in one coronary vessel, including the revascularization methods used in that vessel.
An interventional cardiologist performs this procedure in a cardiac catheterization lab to reopen a chronically and completely occluded coronary vessel using an antegrade crossing approach. The intervention may include balloon angioplasty, atherectomy, or stent placement as needed to restore flow in the treated vessel. Hospital outpatient and inpatient cath lab settings are typical.
Select the code for a chronic total occlusion treated antegrade in one vessel; use the approach and target vessel documented in the procedure report to distinguish it from other coronary intervention codes. The report should identify the occlusion, the vessel treated, the crossing approach, and the revascularization performed. Angioplasty, atherectomy, and stenting in that same vessel are included in the CTO service. The 0-day global period includes same-day preoperative and postoperative care. 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. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 92943
- 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 RVU13.35 · 70%
- Practice expense (office) RVU2.51 · 13%
- Malpractice RVU3.12 · 16%
7K
Medicare services in 2024 · #1665 by national volume
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.
92943 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Use 92941 for revascularization of a total occlusion during an acute myocardial infarction; this code is for chronic total occlusion treatment.
No office rate
92928 reports coronary stent placement for a lesion treated with that service. This code covers CTO revascularization in one vessel, including stenting performed as part of that intervention.
Compare 92943 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$626.44
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$630.13
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$619.67
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92943 billing questions
When should this code be chosen instead of 92945?
Use this code when the CTO is treated through an antegrade approach. Code 92945 is for CTO revascularization using both antegrade and retrograde approaches.
Can angioplasty or stenting in the treated vessel be billed separately?
No. Angioplasty, atherectomy, and stenting performed as part of revascularizing the same CTO vessel are included in this service.
How many units should be reported?
Report one unit for the treated coronary vessel. Document the vessel and antegrade crossing approach in the procedure report.
How does the multiple procedure reduction affect this code?
For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available 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 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.
11,90892933,,Prq trlml c athrc st angiop1,A,,11.64,2.20,NA,2.20,,2.73,16.57,16.57,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,90992937,,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