Cardiology · Illinois

Cardiology commercial reimbursement in Illinois

How Illinois cardiology rates compare with the national market.

Cardiology in Illinois

38 codes · 119 sampled providers
Index vs national
98
2% below
Rank among states
27 of 51
1 = highest
Codes above national
15 of 38
median code at 99%
Providers
119
sampled

What the data shows

1

Cardiology ranks 27th of 51 states in Illinois with an index of 98 (100 = the specialty's national median), across 38 codes and 119 sampled providers.

2

Of the 38 cardiology codes with enough data in Illinois, 15 pay above the national median and 23 below; the typical code sits at 99% of the national median.

3

Largest premium over the national median: CPT 36482 (Endoven ther chem adhes 1st) at 121%; largest discount: CPT 93297 (Rem interrog dev eval icpms) at 89%.

4

Measured against Medicare, Illinois cardiology rates have a median of 141% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeIllinoisNationalGapProv.
36482
Endoven ther chem adhes 1st
$337$278+21%119
36465
Njx noncmpnd sclrsnt 1 vein
$223$185+20%119
93296
Rem interrog evl pm/ids
$45$39+16%119
93000
Electrocardiogram complete
$29$25+14%119
99490
Chrnc care mgmt staff 1st 20
$64$60+6%119

Lowest vs national

CodeIllinoisNationalGapProv.
93297
Rem interrog dev eval icpms
$47$52-11%119
93312
Echo transesophageal
$348$387-10%119
93298
Rem interrog dev eval scrms
$47$52-10%119
93308
Tte f-up or lmtd
$141$155-9%119
93306
Tte w/doppler complete
$290$317-8%119

All cardiology codes in Illinois

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeIllinoisNationalGap% of MedicareProvidersTINsLevel
CPT 36482
Endoven ther chem adhes 1st
$337$278+21%212%119317
CPT 36465
Njx noncmpnd sclrsnt 1 vein
$223$185+21%212%119319
CPT 93296
Rem interrog evl pm/ids
$45$39+16%143%119321
CPT 93000
Electrocardiogram complete
$29$25+14%188%119329
CPT 99490
Chrnc care mgmt staff 1st 20
$64$60+6%96%119321
CPT 99215
Office o/p est hi 40 min
$194$185+5%101%119332
CPT 99214
Office o/p est mod 30 min
$136$131+4%101%119332
CPT 93015
Cv stress test supvj i&r
$123$120+2%167%119325
CPT 99205
Office o/p new hi 60 min
$254$250+2%107%119332
CPT 93016
Cv stress test supvj only
$35$34+2%167%119329
CPT 33361
Replace aortic valve perq
$1,969$1,938+2%182%119318
CPT 33285
Insj subq car rhythm mntr
$137$135+1%181%119320
CPT 99212
Office o/p est sf 10 min
$51$51+1%86%119332
CPT 99457
Rpm tx mgmt 1st 20 min
$53$53+0%102%119320
CPT 99213
Office o/p est low 20 min
$91$91+0%95%119332
CPT 99204
Office o/p new mod 45 min
$191$192-0%108%119332
CPT 99203
Office o/p new low 30 min
$122$122-0%104%119332
CPT 92928
Prq tcat plmt ntrac st 1 les
$877$887-1%189%119324
CPT 93656
Compre ep eval abltj atr fib
$1,593$1,615-1%198%119322
CPT 93229
Remote 30 day ecg tech supp
$1,071$1,088-2%141%118316
CPT 93010
Electrocardiogram report
$12$13-2%148%119329
CPT 33208
Insrt heart pm atrial & vent
$798$819-3%175%119321
CPT 20610
Drain/inj joint/bursa w/o us
$81$83-3%117%119321
CPT 78452
Ht muscle image spect mult
$588$609-3%137%119327
CPT 93458
L hrt artery/ventricle angio
$1,518$1,573-3%150%119322
CPT 75574
Ct angio hrt w/3d image
$472$495-5%145%119320
CPT 93280
Pm device progr eval dual
$101$105-5%128%119322
CPT 93294
Rem interrog evl pm/ldls pm
$46$48-5%155%119325
CPT 93925
Lower extremity study
$329$349-6%138%119326
CPT 93970
Extremity study
$258$275-6%140%119326
CPT 93351
Stress tte complete
$343$366-6%147%119326
CPT 93880
Extracranial bilat study
$262$283-7%139%119327
CPT 99454
Rem mntr physiol param 16-30
$69$75-8%133%119321
CPT 93306
Tte w/doppler complete
$290$317-8%147%119330
CPT 93308
Tte f-up or lmtd
$141$155-9%139%119327
CPT 93298
Rem interrog dev eval scrms
$47$52-10%46%119321
CPT 93312
Echo transesophageal
$348$387-10%145%119327
CPT 93297
Rem interrog dev eval icpms
$47$52-11%77%119318

Frequently asked questions

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

Illinois ranks 27th of 51 states with an index of 98; 15 of 38 codes are above the national median.

Which cardiology code has the biggest premium in Illinois?

CPT 36482 (Endoven ther chem adhes 1st), at 121% 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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