Cardiology · Rhode Island

Cardiology commercial reimbursement in Rhode Island

How Rhode Island cardiology rates compare with the national market.

Cardiology in Rhode Island

38 codes · 91 sampled providers
Index vs national
107
7% above
Rank among states
17 of 51
1 = highest
Codes above national
28 of 38
median code at 109%
Providers
91
sampled

What the data shows

1

Cardiology ranks 17th of 51 states in Rhode Island with an index of 107 (100 = the specialty's national median), across 38 codes and 91 sampled providers.

2

Of the 38 cardiology codes with enough data in Rhode Island, 28 pay above the national median and 10 below; the typical code sits at 109% of the national median.

3

Largest premium over the national median: CPT 75574 (Ct angio hrt w/3d image) at 128%; largest discount: CPT 33361 (Replace aortic valve perq) at 89%.

4

Measured against Medicare, Rhode Island cardiology rates have a median of 160% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeRhode IslaNationalGapProv.
75574
Ct angio hrt w/3d image
$634$495+28%91
93656
Compre ep eval abltj atr fib
$2,010$1,615+24%91
92928
Prq tcat plmt ntrac st 1 les
$1,055$887+19%91
93010
Electrocardiogram report
$15$13+18%91
93296
Rem interrog evl pm/ids
$45$39+16%91

Lowest vs national

CodeRhode IslaNationalGapProv.
33361
Replace aortic valve perq
$1,727$1,938-11%91
33285
Insj subq car rhythm mntr
$122$135-10%90
99454
Rem mntr physiol param 16-30
$67$75-10%91
93925
Lower extremity study
$314$349-10%91
33208
Insrt heart pm atrial & vent
$745$819-9%91

All cardiology codes in Rhode Island

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeRhode IslandNationalGap% of MedicareProvidersTINsLevel
CPT 75574
Ct angio hrt w/3d image
$634$495+28%195%91104
CPT 93656
Compre ep eval abltj atr fib
$2,010$1,615+24%249%91116
CPT 92928
Prq tcat plmt ntrac st 1 les
$1,055$887+19%227%91116
CPT 93010
Electrocardiogram report
$15$13+18%178%91106
CPT 93296
Rem interrog evl pm/ids
$45$39+16%143%91106
CPT 93306
Tte w/doppler complete
$367$317+16%186%91115
CPT 93000
Electrocardiogram complete
$29$25+15%190%91115
CPT 99203
Office o/p new low 30 min
$141$122+15%120%91117
CPT 93229
Remote 30 day ecg tech supp
$1,249$1,088+15%165%91113
CPT 93294
Rem interrog evl pm/ldls pm
$55$48+15%187%91106
CPT 93016
Cv stress test supvj only
$39$34+14%188%91106
CPT 93351
Stress tte complete
$415$366+13%178%91116
CPT 93308
Tte f-up or lmtd
$175$155+13%173%91114
CPT 93312
Echo transesophageal
$435$387+12%181%91105
CPT 20610
Drain/inj joint/bursa w/o us
$93$83+12%135%91107
CPT 78452
Ht muscle image spect mult
$681$609+12%159%91106
CPT 99457
Rpm tx mgmt 1st 20 min
$58$53+10%112%91107
CPT 99214
Office o/p est mod 30 min
$144$131+10%106%91116
CPT 93280
Pm device progr eval dual
$115$105+9%147%91116
CPT 93015
Cv stress test supvj i&r
$129$120+7%175%91115
CPT 99215
Office o/p est hi 40 min
$197$185+7%102%91116
CPT 93458
L hrt artery/ventricle angio
$1,675$1,573+6%166%91103
CPT 99205
Office o/p new hi 60 min
$262$250+5%110%91117
CPT 99204
Office o/p new mod 45 min
$199$192+4%112%91118
CPT 36482
Endoven ther chem adhes 1st
$287$278+3%181%90113
CPT 99213
Office o/p est low 20 min
$93$91+3%98%91116
CPT 99490
Chrnc care mgmt staff 1st 20
$61$60+3%93%91106
CPT 36465
Njx noncmpnd sclrsnt 1 vein
$189$185+2%179%90114
CPT 99212
Office o/p est sf 10 min
$51$51-0%86%91116
CPT 93297
Rem interrog dev eval icpms
$52$52-0%86%91116
CPT 93298
Rem interrog dev eval scrms
$52$52-1%50%91117
CPT 93970
Extremity study
$252$275-9%137%91115
CPT 93880
Extracranial bilat study
$258$283-9%137%91116
CPT 33208
Insrt heart pm atrial & vent
$745$819-9%163%91116
CPT 93925
Lower extremity study
$314$349-10%132%91115
CPT 99454
Rem mntr physiol param 16-30
$67$75-10%129%91107
CPT 33285
Insj subq car rhythm mntr
$122$135-10%160%90115
CPT 33361
Replace aortic valve perq
$1,727$1,938-11%160%91116

Frequently asked questions

How do Rhode Island cardiology rates compare with the rest of the country?

Rhode Island ranks 17th of 51 states with an index of 107; 28 of 38 codes are above the national median.

Which cardiology code has the biggest premium in Rhode Island?

CPT 75574 (Ct angio hrt w/3d image), at 128% 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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