CPT 92928
Global 000 ActivePrq tcat plmt ntrac st 1 les
CPT 92928 Billing & Documentation Guide
CPT code 92928 (Prq tcat plmt ntrac st 1 les) is classified under Cardiovascular with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 9.75, a non-facility practice expense RVU of 1.84, and a malpractice RVU of 2.3, a total non-facility RVU of 13.89 and facility RVU of 13.89. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $462.21, though rates vary from $408.2 to $596.27 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92928, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 92928 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 3 units of 92928 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 92928
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 9.75 | 9.75 |
| Practice Expense RVU | 1.84 | 1.84 |
| Malpractice RVU | 2.3 | 2.3 |
| Total RVU | 13.89 | 13.89 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92928
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $451.71 | $451.71 | $439.73 - $491.28 | 29 |
| Florida | $536.87 | $536.87 | $499.88 - $583.92 | 3 |
| Georgia | $476.7 | $476.7 | $472.05 - $481.34 | 2 |
| Illinois | $532.99 | $532.99 | $501.84 - $566.01 | 4 |
| Michigan | $491.5 | $491.5 | $468.5 - $514.49 | 2 |
| North Carolina | $432.09 | $432.09 | $432.09 - $432.09 | 1 |
| New York | $514.1 | $514.1 | $438.05 - $562.23 | 5 |
| Ohio | $459.21 | $459.21 | $459.21 - $459.21 | 1 |
| Pennsylvania | $470.91 | $470.91 | $454.67 - $487.15 | 2 |
| Texas | $459.31 | $459.31 | $449.09 - $495 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 92928
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92928 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01924 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01925 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01926 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0216T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0632T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92928
What does CPT code 92928 mean? +
CPT code 92928 represents: Prq tcat plmt ntrac st 1 les. It's in the Cardiovascular category with a global period of 000.
What is the Medicare reimbursement for CPT 92928? +
The 2026 Medicare national average non-facility payment for CPT 92928 is $462.21. Rates range from $408.2 to $596.27 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92928? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 92928? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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