Cardiology · Pennsylvania
Cardiology commercial reimbursement in Pennsylvania
How Pennsylvania cardiology rates compare with the national market.
Cardiology in Pennsylvania
38 codes · 98 sampled providers
Index vs national
98
2% below
Rank among states
29 of 51
1 = highest
Codes above national
13 of 38
median code at 98%
Providers
98
sampled
What the data shows
1
Cardiology ranks 29th of 51 states in Pennsylvania with an index of 98 (100 = the specialty's national median), across 38 codes and 98 sampled providers.
2
Of the 38 cardiology codes with enough data in Pennsylvania, 13 pay above the national median and 25 below; the typical code sits at 98% of the national median.
3
Largest premium over the national median: CPT 99214 (Office o/p est mod 30 min) at 110%; largest discount: CPT 33208 (Insrt heart pm atrial & vent) at 89%.
4
Measured against Medicare, Pennsylvania cardiology rates have a median of 150% of the Medicare rate across these codes.
Codes above and below the national median
The five largest gaps in each direction
Highest vs national
All cardiology codes in Pennsylvania
Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
| Code | Pennsylvania | National | Gap | % of Medicare | Providers | TINs | Level |
|---|---|---|---|---|---|---|---|
| CPT 99214 Office o/p est mod 30 min | $144 | $131 | +10% | 106% | 98 | 173 | |
| CPT 99215 Office o/p est hi 40 min | $200 | $185 | +8% | 104% | 98 | 177 | |
| CPT 99204 Office o/p new mod 45 min | $206 | $192 | +7% | 116% | 98 | 177 | |
| CPT 99213 Office o/p est low 20 min | $96 | $91 | +6% | 101% | 98 | 180 | |
| CPT 99212 Office o/p est sf 10 min | $54 | $51 | +6% | 91% | 98 | 180 | |
| CPT 99203 Office o/p new low 30 min | $130 | $122 | +6% | 110% | 98 | 184 | |
| CPT 99205 Office o/p new hi 60 min | $264 | $250 | +6% | 112% | 98 | 174 | |
| CPT 78452 Ht muscle image spect mult | $641 | $609 | +5% | 150% | 98 | 193 | |
| CPT 99457 Rpm tx mgmt 1st 20 min | $55 | $53 | +5% | 107% | 98 | 186 | |
| CPT 93925 Lower extremity study | $364 | $349 | +4% | 153% | 98 | 191 | |
| CPT 93970 Extremity study | $281 | $275 | +2% | 153% | 98 | 191 | |
| CPT 93880 Extracranial bilat study | $285 | $283 | +1% | 151% | 98 | 191 | |
| CPT 99490 Chrnc care mgmt staff 1st 20 | $60 | $60 | +0% | 91% | 98 | 189 | |
| CPT 93458 L hrt artery/ventricle angio | $1,549 | $1,573 | -2% | 153% | 98 | 188 | |
| CPT 93312 Echo transesophageal | $381 | $387 | -2% | 159% | 98 | 192 | |
| CPT 75574 Ct angio hrt w/3d image | $487 | $495 | -2% | 150% | 98 | 191 | |
| CPT 36482 Endoven ther chem adhes 1st | $273 | $278 | -2% | 172% | 98 | 163 | |
| CPT 93229 Remote 30 day ecg tech supp | $1,062 | $1,088 | -2% | 140% | 97 | 173 | |
| CPT 93308 Tte f-up or lmtd | $151 | $155 | -2% | 149% | 98 | 189 | |
| CPT 93351 Stress tte complete | $357 | $366 | -2% | 153% | 98 | 189 | |
| CPT 33361 Replace aortic valve perq | $1,870 | $1,938 | -4% | 173% | 98 | 189 | |
| CPT 99454 Rem mntr physiol param 16-30 | $72 | $75 | -4% | 138% | 98 | 186 | |
| CPT 93296 Rem interrog evl pm/ids | $38 | $39 | -4% | 118% | 98 | 189 | |
| CPT 93298 Rem interrog dev eval scrms | $50 | $52 | -4% | 49% | 98 | 189 | |
| CPT 93000 Electrocardiogram complete | $24 | $25 | -4% | 158% | 98 | 194 | |
| CPT 93306 Tte w/doppler complete | $302 | $317 | -5% | 154% | 98 | 193 | |
| CPT 93010 Electrocardiogram report | $12 | $13 | -5% | 144% | 98 | 194 | |
| CPT 93297 Rem interrog dev eval icpms | $50 | $52 | -5% | 82% | 98 | 186 | |
| CPT 92928 Prq tcat plmt ntrac st 1 les | $832 | $887 | -6% | 179% | 98 | 192 | |
| CPT 93280 Pm device progr eval dual | $99 | $105 | -6% | 126% | 98 | 189 | |
| CPT 20610 Drain/inj joint/bursa w/o us | $78 | $83 | -7% | 113% | 98 | 196 | |
| CPT 93015 Cv stress test supvj i&r | $112 | $120 | -7% | 152% | 98 | 192 | |
| CPT 93016 Cv stress test supvj only | $32 | $34 | -7% | 153% | 98 | 190 | |
| CPT 93294 Rem interrog evl pm/ldls pm | $44 | $48 | -8% | 151% | 98 | 189 | |
| CPT 33285 Insj subq car rhythm mntr | $125 | $135 | -8% | 165% | 98 | 168 | |
| CPT 36465 Njx noncmpnd sclrsnt 1 vein | $168 | $185 | -10% | 159% | 98 | 164 | |
| CPT 93656 Compre ep eval abltj atr fib | $1,460 | $1,615 | -10% | 181% | 98 | 189 | |
| CPT 33208 Insrt heart pm atrial & vent | $732 | $819 | -11% | 160% | 98 | 169 |
Frequently asked questions
How do Pennsylvania cardiology rates compare with the rest of the country?
Pennsylvania ranks 29th of 51 states with an index of 98; 13 of 38 codes are above the national median.
Which cardiology code has the biggest premium in Pennsylvania?
CPT 99214 (Office o/p est mod 30 min), at 110% 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.
Benchmark your Pennsylvania cardiology contracts
Compare your rates with these medians.