Cardiology · New Jersey

Cardiology commercial reimbursement in New Jersey

How New Jersey cardiology rates compare with the national market.

Cardiology in New Jersey

38 codes · 113 sampled providers
Index vs national
101
1% above
Rank among states
24 of 51
1 = highest
Codes above national
21 of 38
median code at 102%
Providers
113
sampled

What the data shows

1

Cardiology ranks 24th of 51 states in New Jersey with an index of 101 (100 = the specialty's national median), across 38 codes and 113 sampled providers.

2

Of the 38 cardiology codes with enough data in New Jersey, 21 pay above the national median and 17 below; the typical code sits at 102% of the national median.

3

Largest premium over the national median: CPT 99454 (Rem mntr physiol param 16-30) at 117%; largest discount: CPT 93280 (Pm device progr eval dual) at 93%.

4

Measured against Medicare, New Jersey cardiology rates have a median of 157% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeNew JerseyNationalGapProv.
99454
Rem mntr physiol param 16-30
$87$75+17%113
93970
Extremity study
$312$275+13%113
93880
Extracranial bilat study
$316$283+12%113
99204
Office o/p new mod 45 min
$209$192+9%113
99214
Office o/p est mod 30 min
$143$131+9%113

Lowest vs national

CodeNew JerseyNationalGapProv.
93280
Pm device progr eval dual
$98$105-7%113
93297
Rem interrog dev eval icpms
$49$52-6%113
33285
Insj subq car rhythm mntr
$128$135-6%113
36465
Njx noncmpnd sclrsnt 1 vein
$177$185-5%113
33208
Insrt heart pm atrial & vent
$781$819-5%113

All cardiology codes in New Jersey

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNew JerseyNationalGap% of MedicareProvidersTINsLevel
CPT 99454
Rem mntr physiol param 16-30
$87$75+17%168%113219
CPT 93970
Extremity study
$312$275+13%169%113215
CPT 93880
Extracranial bilat study
$316$283+12%167%113216
CPT 99204
Office o/p new mod 45 min
$209$192+9%118%113221
CPT 99214
Office o/p est mod 30 min
$143$131+9%105%113221
CPT 99457
Rpm tx mgmt 1st 20 min
$57$53+9%111%113219
CPT 99203
Office o/p new low 30 min
$132$122+8%113%113221
CPT 93306
Tte w/doppler complete
$338$317+7%172%113221
CPT 93296
Rem interrog evl pm/ids
$42$39+6%131%113221
CPT 93308
Tte f-up or lmtd
$164$155+6%162%113221
CPT 99215
Office o/p est hi 40 min
$193$185+5%100%113221
CPT 93925
Lower extremity study
$365$349+5%154%113215
CPT 93312
Echo transesophageal
$403$387+4%168%113221
CPT 99212
Office o/p est sf 10 min
$53$51+4%89%113221
CPT 99205
Office o/p new hi 60 min
$259$250+4%109%113221
CPT 99213
Office o/p est low 20 min
$93$91+3%98%113221
CPT 93298
Rem interrog dev eval scrms
$54$52+3%52%113221
CPT 93351
Stress tte complete
$375$366+3%161%113221
CPT 78452
Ht muscle image spect mult
$623$609+2%145%113216
CPT 93458
L hrt artery/ventricle angio
$1,582$1,573+1%157%113221
CPT 20610
Drain/inj joint/bursa w/o us
$84$83+1%122%113219
CPT 93229
Remote 30 day ecg tech supp
$1,081$1,088-1%143%111216
CPT 93656
Compre ep eval abltj atr fib
$1,604$1,615-1%199%113220
CPT 93010
Electrocardiogram report
$13$13-1%150%113221
CPT 93000
Electrocardiogram complete
$25$25-1%164%113221
CPT 93015
Cv stress test supvj i&r
$118$120-1%161%113220
CPT 33361
Replace aortic valve perq
$1,910$1,938-1%177%113218
CPT 92928
Prq tcat plmt ntrac st 1 les
$869$887-2%187%113221
CPT 75574
Ct angio hrt w/3d image
$485$495-2%149%110208
CPT 99490
Chrnc care mgmt staff 1st 20
$58$60-2%88%111218
CPT 93294
Rem interrog evl pm/ldls pm
$47$48-3%159%113221
CPT 93016
Cv stress test supvj only
$33$34-3%159%113221
CPT 36482
Endoven ther chem adhes 1st
$265$278-5%167%111215
CPT 33208
Insrt heart pm atrial & vent
$781$819-5%171%113219
CPT 36465
Njx noncmpnd sclrsnt 1 vein
$177$185-5%167%113215
CPT 33285
Insj subq car rhythm mntr
$128$135-6%169%113213
CPT 93297
Rem interrog dev eval icpms
$49$52-6%80%113220
CPT 93280
Pm device progr eval dual
$98$105-7%125%113219

Frequently asked questions

How do New Jersey cardiology rates compare with the rest of the country?

New Jersey ranks 24th of 51 states with an index of 101; 21 of 38 codes are above the national median.

Which cardiology code has the biggest premium in New Jersey?

CPT 99454 (Rem mntr physiol param 16-30), at 117% 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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