Cardiology · California

Cardiology commercial reimbursement in California

How California cardiology rates compare with the national market.

Cardiology in California

38 codes · 108 sampled providers
Index vs national
89
11% below
Rank among states
40 of 51
1 = highest
Codes above national
6 of 38
median code at 89%
Providers
108
sampled

What the data shows

1

Cardiology ranks 40th of 51 states in California with an index of 89 (100 = the specialty's national median), across 38 codes and 108 sampled providers.

2

Of the 38 cardiology codes with enough data in California, 6 pay above the national median and 32 below; the typical code sits at 89% of the national median.

3

Largest premium over the national median: CPT 93000 (Electrocardiogram complete) at 113%; largest discount: CPT 93297 (Rem interrog dev eval icpms) at 67%.

4

Measured against Medicare, California cardiology rates have a median of 134% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeCaliforniaNationalGapProv.
93000
Electrocardiogram complete
$29$25+13%107
99454
Rem mntr physiol param 16-30
$80$75+7%108
93296
Rem interrog evl pm/ids
$41$39+6%108
93312
Echo transesophageal
$399$387+3%107
99457
Rpm tx mgmt 1st 20 min
$53$53+1%108

Lowest vs national

CodeCaliforniaNationalGapProv.
93297
Rem interrog dev eval icpms
$35$52-33%108
36465
Njx noncmpnd sclrsnt 1 vein
$128$185-31%106
36482
Endoven ther chem adhes 1st
$203$278-27%106
33285
Insj subq car rhythm mntr
$102$135-25%106
93298
Rem interrog dev eval scrms
$41$52-21%108

All cardiology codes in California

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeCaliforniaNationalGap% of MedicareProvidersTINsLevel
CPT 93000
Electrocardiogram complete
$29$25+13%187%107408
CPT 99454
Rem mntr physiol param 16-30
$80$75+7%154%108404
CPT 93296
Rem interrog evl pm/ids
$41$39+6%131%108408
CPT 93312
Echo transesophageal
$399$387+3%167%107403
CPT 99457
Rpm tx mgmt 1st 20 min
$53$53+1%103%108404
CPT 93970
Extremity study
$278$275+1%151%108406
CPT 93306
Tte w/doppler complete
$315$317-0%160%107404
CPT 99212
Office o/p est sf 10 min
$51$51-0%85%108407
CPT 93015
Cv stress test supvj i&r
$119$120-1%161%107405
CPT 99203
Office o/p new low 30 min
$117$122-4%100%108408
CPT 99204
Office o/p new mod 45 min
$180$192-6%102%108409
CPT 78452
Ht muscle image spect mult
$573$609-6%134%108407
CPT 99490
Chrnc care mgmt staff 1st 20
$56$60-6%85%107399
CPT 99213
Office o/p est low 20 min
$84$91-7%89%108406
CPT 20610
Drain/inj joint/bursa w/o us
$76$83-9%111%108405
CPT 99214
Office o/p est mod 30 min
$119$131-9%88%108408
CPT 93880
Extracranial bilat study
$257$283-9%136%108407
CPT 99205
Office o/p new hi 60 min
$227$250-9%96%108408
CPT 75574
Ct angio hrt w/3d image
$443$495-11%136%108405
CPT 93308
Tte f-up or lmtd
$138$155-11%137%107404
CPT 93458
L hrt artery/ventricle angio
$1,406$1,573-11%139%107406
CPT 93280
Pm device progr eval dual
$94$105-11%120%108407
CPT 93351
Stress tte complete
$324$366-11%139%107406
CPT 93010
Electrocardiogram report
$11$13-12%132%107406
CPT 93294
Rem interrog evl pm/ldls pm
$42$48-13%142%107404
CPT 93925
Lower extremity study
$301$349-14%127%108408
CPT 93016
Cv stress test supvj only
$29$34-14%141%107407
CPT 99215
Office o/p est hi 40 min
$158$185-14%82%108408
CPT 93656
Compre ep eval abltj atr fib
$1,343$1,615-17%166%107404
CPT 33361
Replace aortic valve perq
$1,586$1,938-18%147%107405
CPT 92928
Prq tcat plmt ntrac st 1 les
$720$887-19%155%107407
CPT 33208
Insrt heart pm atrial & vent
$664$819-19%146%107404
CPT 93229
Remote 30 day ecg tech supp
$872$1,088-20%115%108401
CPT 93298
Rem interrog dev eval scrms
$41$52-21%40%108408
CPT 33285
Insj subq car rhythm mntr
$102$135-25%135%106399
CPT 36482
Endoven ther chem adhes 1st
$203$278-27%128%106396
CPT 36465
Njx noncmpnd sclrsnt 1 vein
$128$185-31%122%106398
CPT 93297
Rem interrog dev eval icpms
$35$52-33%58%108408

Frequently asked questions

How do California cardiology rates compare with the rest of the country?

California ranks 40th of 51 states with an index of 89; 6 of 38 codes are above the national median.

Which cardiology code has the biggest premium in California?

CPT 93000 (Electrocardiogram complete), at 113% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • 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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