Cardiology · Massachusetts

Cardiology commercial reimbursement in Massachusetts

How Massachusetts cardiology rates compare with the national market.

Cardiology in Massachusetts

38 codes · 109 sampled providers
Index vs national
133
33% above
Rank among states
9 of 51
1 = highest
Codes above national
38 of 38
median code at 133%
Providers
109
sampled

What the data shows

1

Cardiology ranks 9th of 51 states in Massachusetts with an index of 133 (100 = the specialty's national median), across 38 codes and 109 sampled providers.

2

Of the 38 cardiology codes with enough data in Massachusetts, 38 pay above the national median and 0 below; the typical code sits at 133% of the national median.

3

Largest premium over the national median: CPT 93298 (Rem interrog dev eval scrms) at 239%; largest discount: CPT 93656 (Compre ep eval abltj atr fib) at 111%.

4

Measured against Medicare, Massachusetts cardiology rates have a median of 206% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMassachuseNationalGapProv.
93298
Rem interrog dev eval scrms
$125$52+139%108
93297
Rem interrog dev eval icpms
$101$52+92%107
93229
Remote 30 day ecg tech supp
$1,634$1,088+50%107
93280
Pm device progr eval dual
$156$105+48%108
99490
Chrnc care mgmt staff 1st 20
$88$60+48%105

Lowest vs national

CodeMassachuseNationalGapProv.
93656
Compre ep eval abltj atr fib
$1,786$1,615+11%108
78452
Ht muscle image spect mult
$681$609+12%105
33361
Replace aortic valve perq
$2,234$1,938+15%107
20610
Drain/inj joint/bursa w/o us
$98$83+18%106
33208
Insrt heart pm atrial & vent
$974$819+19%108

All cardiology codes in Massachusetts

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMassachusettNationalGap% of MedicareProvidersTINsLevel
CPT 93298
Rem interrog dev eval scrms
$125$52+139%121%108249
CPT 93297
Rem interrog dev eval icpms
$101$52+92%165%107236
CPT 93229
Remote 30 day ecg tech supp
$1,634$1,088+50%215%107241
CPT 93280
Pm device progr eval dual
$156$105+48%199%108249
CPT 99490
Chrnc care mgmt staff 1st 20
$88$60+48%134%105162
CPT 99215
Office o/p est hi 40 min
$268$185+45%139%109248
CPT 93925
Lower extremity study
$504$349+45%212%107233
CPT 93296
Rem interrog evl pm/ids
$56$39+42%175%104157
CPT 93970
Extremity study
$391$275+42%213%108239
CPT 93308
Tte f-up or lmtd
$220$155+42%217%107239
CPT 99214
Office o/p est mod 30 min
$186$131+42%137%109251
CPT 93880
Extracranial bilat study
$397$283+40%210%109249
CPT 93351
Stress tte complete
$512$366+40%219%108248
CPT 99205
Office o/p new hi 60 min
$344$250+37%145%109249
CPT 93010
Electrocardiogram report
$17$13+37%206%104157
CPT 93306
Tte w/doppler complete
$432$317+37%220%109249
CPT 99213
Office o/p est low 20 min
$124$91+36%130%109251
CPT 99454
Rem mntr physiol param 16-30
$100$75+33%191%104162
CPT 99204
Office o/p new mod 45 min
$255$192+33%144%109249
CPT 99212
Office o/p est sf 10 min
$68$51+33%114%109248
CPT 93458
L hrt artery/ventricle angio
$2,090$1,573+33%207%104160
CPT 99203
Office o/p new low 30 min
$160$122+31%136%109248
CPT 93016
Cv stress test supvj only
$44$34+29%212%104157
CPT 93312
Echo transesophageal
$496$387+28%207%104160
CPT 93294
Rem interrog evl pm/ldls pm
$61$48+27%208%103158
CPT 93015
Cv stress test supvj i&r
$151$120+26%206%109244
CPT 93000
Electrocardiogram complete
$32$25+25%206%108247
CPT 33285
Insj subq car rhythm mntr
$166$135+23%219%107246
CPT 99457
Rpm tx mgmt 1st 20 min
$65$53+23%125%106167
CPT 92928
Prq tcat plmt ntrac st 1 les
$1,086$887+22%234%108249
CPT 36465
Njx noncmpnd sclrsnt 1 vein
$226$185+22%214%106228
CPT 75574
Ct angio hrt w/3d image
$603$495+22%185%104158
CPT 36482
Endoven ther chem adhes 1st
$338$278+22%213%106227
CPT 33208
Insrt heart pm atrial & vent
$974$819+19%214%108249
CPT 20610
Drain/inj joint/bursa w/o us
$98$83+18%142%106171
CPT 33361
Replace aortic valve perq
$2,234$1,938+15%207%107239
CPT 78452
Ht muscle image spect mult
$681$609+12%159%105160
CPT 93656
Compre ep eval abltj atr fib
$1,786$1,615+11%221%108249

Frequently asked questions

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

Massachusetts ranks 9th of 51 states with an index of 133; 38 of 38 codes are above the national median.

Which cardiology code has the biggest premium in Massachusetts?

CPT 93298 (Rem interrog dev eval scrms), at 239% 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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