Procedures with the widest gap between payers
Metric: highest payer median / lowest payer median.
What the data shows
CPT 64566 (Neuroeltrd stim post tibial) ranks first at 3.30; CPT 26055 (Incise finger tendon sheath) ranks last of 25 at 2.04.
The spread between first and last is 1.62× (1.26 points on this metric).
The median value across the 25 items is 2.39.
How to read this ranking
Each row is a procedure code. Ratios compare the national median commercial rate with the Medicare physician fee schedule (or the spread between payers or states), so a higher number means a larger commercial premium or a wider gap.
Procedures with the widest gap between payers
| Rank | Item | Value | Level |
|---|---|---|---|
| 1 | CPT 64566 Neuroeltrd stim post tibial | 3.30 | |
| 2 | CPT 52224 Cystoscopy and treatment | 3.25 | |
| 3 | CPT 52332 Cystoscopy and treatment | 2.88 | |
| 4 | CPT 52648 Laser surgery of prostate | 2.82 | |
| 5 | CPT 11102 Tangntl bx skin single les | 2.77 | |
| 5 | CPT 11104 Punch bx skin single lesion | 2.77 | |
| 7 | CPT 93298 Rem interrog dev eval scrms | 2.70 | |
| 8 | CPT 51702 Insert temp bladder cath | 2.66 | |
| 9 | CPT 43255 Egd control bleeding any | 2.53 | |
| 10 | CPT 51700 Irrigation of bladder | 2.44 | |
| 11 | CPT 43251 Egd remove lesion snare | 2.42 | |
| 12 | CPT 43239 Egd biopsy single/multiple | 2.39 | |
| 12 | CPT 52287 Cystoscopy chemodenervation | 2.39 | |
| 14 | CPT 99457 Rpm tx mgmt 1st 20 min | 2.37 | |
| 15 | CPT 43248 Egd guide wire insertion | 2.36 | |
| 15 | CPT 52000 Cystourethroscopy | 2.36 | |
| 17 | CPT 11301 Shave skin lesion 0.6-1.0 cm | 2.34 | |
| 17 | CPT 11302 Shave skin lesion 1.1-2.0 cm | 2.34 | |
| 19 | CPT 52281 Cystoscopy and treatment | 2.31 | |
| 20 | CPT 43235 Egd diagnostic brush wash | 2.27 | |
| 21 | CPT 45384 Colonoscopy w/lesion removal | 2.24 | |
| 22 | CPT 52310 Cystoscopy and treatment | 2.08 | |
| 23 | CPT 45380 Colonoscopy and biopsy | 2.07 | |
| 24 | CPT 51720 Treatment of bladder lesion | 2.06 | |
| 25 | CPT 26055 Incise finger tendon sheath | 2.04 |
Frequently asked questions
What does this ranking measure?
highest payer median / lowest payer median. Each row is a procedure code. Ratios compare the national median commercial rate with the Medicare physician fee schedule (or the spread between payers or states), so a higher number means a larger commercial premium or a wider gap.
Who ranks first?
CPT 64566 (Neuroeltrd stim post tibial), at 3.30.
How often is this updated?
It is rebuilt from each monthly snapshot of the payers' published files; this page uses August 2026.
Methodology
- Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
- Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
- Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
- Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
- Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
- Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.
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