Procedures with the widest gap between states
Metric: highest state median / lowest state median.
What the data shows
CPT 93297 (Rem interrog dev eval icpms) ranks first at 5.62; CPT 75574 (Ct angio hrt w/3d image) ranks last of 25 at 4.51.
The spread between first and last is 1.25× (1.11 points on this metric).
The median value across the 25 items is 4.85.
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 states
| Rank | Item | Value | Level |
|---|---|---|---|
| 1 | CPT 93297 Rem interrog dev eval icpms | 5.62 | |
| 2 | CPT 93298 Rem interrog dev eval scrms | 5.38 | |
| 3 | CPT 65820 Goniotomy | 5.23 | |
| 4 | CPT 76512 Oph us dx b-scan | 5.20 | |
| 5 | CPT 73564 X-ray exam knee 4 or more | 5.00 | |
| 6 | CPT 72100 X-ray exam l-s spine 2/3 vws | 4.96 | |
| 7 | CPT 65756 Corneal trnspl endothelial | 4.94 | |
| 8 | CPT 73030 X-ray exam of shoulder | 4.91 | |
| 8 | CPT 67042 Vit for macular hole | 4.91 | |
| 10 | CPT 66991 Xcapsl ctrc rmvl insj 1+ | 4.90 | |
| 11 | CPT 45384 Colonoscopy w/lesion removal | 4.88 | |
| 12 | CPT 73562 X-ray exam of knee 3 | 4.85 | |
| 12 | CPT 66984 Xcapsl ctrc rmvl w/o ecp | 4.85 | |
| 12 | CPT 66982 Xcapsl ctrc rmvl cplx wo ecp | 4.85 | |
| 15 | CPT 66821 After cataract laser surgery | 4.82 | |
| 15 | CPT 67210 Treatment of retinal lesion | 4.82 | |
| 17 | CPT 73610 X-ray exam of ankle | 4.80 | |
| 18 | CPT 72110 X-ray exam l-2 spine 4/>vws | 4.77 | |
| 19 | CPT 73630 X-ray exam of foot | 4.69 | |
| 20 | CPT 76872 Us transrectal | 4.67 | |
| 21 | CPT 73560 X-ray exam of knee 1 or 2 | 4.64 | |
| 22 | CPT 88312 Special stains group 1 | 4.63 | |
| 23 | CPT 76775 Us exam abdo back wall lim | 4.59 | |
| 24 | CPT 15823 Blepharp upr eyelid xcsv skn | 4.51 | |
| 24 | CPT 75574 Ct angio hrt w/3d image | 4.51 |
Frequently asked questions
What does this ranking measure?
highest state median / lowest state 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 93297 (Rem interrog dev eval icpms), at 5.62.
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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