Cardiology · Texas

Cardiology commercial reimbursement in Texas

How Texas cardiology rates compare with the national market.

Cardiology in Texas

38 codes · 131 sampled providers
Index vs national
80
20% below
Rank among states
48 of 51
1 = highest
Codes above national
0 of 38
median code at 80%
Providers
131
sampled

What the data shows

1

Cardiology ranks 48th of 51 states in Texas with an index of 80 (100 = the specialty's national median), across 38 codes and 131 sampled providers.

2

Of the 38 cardiology codes with enough data in Texas, 0 pay above the national median and 38 below; the typical code sits at 80% of the national median.

3

Largest premium over the national median: CPT 93297 (Rem interrog dev eval icpms) at 100%; largest discount: CPT 75574 (Ct angio hrt w/3d image) at 68%.

4

Measured against Medicare, Texas cardiology rates have a median of 112% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeTexasNationalGapProv.
93297
Rem interrog dev eval icpms
$52$52-0%130
93298
Rem interrog dev eval scrms
$51$52-2%130
93229
Remote 30 day ecg tech supp
$938$1,088-14%130
99490
Chrnc care mgmt staff 1st 20
$51$60-14%130
99212
Office o/p est sf 10 min
$44$51-14%130

Lowest vs national

CodeTexasNationalGapProv.
75574
Ct angio hrt w/3d image
$338$495-32%130
78452
Ht muscle image spect mult
$428$609-30%130
93351
Stress tte complete
$260$366-29%130
93306
Tte w/doppler complete
$226$317-29%130
93312
Echo transesophageal
$276$387-29%130

All cardiology codes in Texas

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeTexasNationalGap% of MedicareProvidersTINsLevel
CPT 93297
Rem interrog dev eval icpms
$52$52-0%86%130296
CPT 93298
Rem interrog dev eval scrms
$51$52-2%50%130298
CPT 93229
Remote 30 day ecg tech supp
$938$1,088-14%124%130294
CPT 99490
Chrnc care mgmt staff 1st 20
$51$60-14%78%130295
CPT 99212
Office o/p est sf 10 min
$44$51-14%74%130303
CPT 99205
Office o/p new hi 60 min
$212$250-15%90%131305
CPT 99214
Office o/p est mod 30 min
$110$131-16%81%130304
CPT 99204
Office o/p new mod 45 min
$161$192-16%91%131307
CPT 36482
Endoven ther chem adhes 1st
$232$278-16%146%130286
CPT 99203
Office o/p new low 30 min
$102$122-16%87%130303
CPT 99213
Office o/p est low 20 min
$76$91-17%79%130306
CPT 93010
Electrocardiogram report
$11$13-17%126%130298
CPT 92928
Prq tcat plmt ntrac st 1 les
$733$887-17%158%130299
CPT 20610
Drain/inj joint/bursa w/o us
$68$83-19%99%130295
CPT 99215
Office o/p est hi 40 min
$150$185-19%78%130304
CPT 99457
Rpm tx mgmt 1st 20 min
$43$53-19%82%130294
CPT 33361
Replace aortic valve perq
$1,565$1,938-19%145%130290
CPT 93294
Rem interrog evl pm/ldls pm
$39$48-19%132%130297
CPT 93656
Compre ep eval abltj atr fib
$1,296$1,615-20%161%130296
CPT 33285
Insj subq car rhythm mntr
$108$135-20%143%130295
CPT 33208
Insrt heart pm atrial & vent
$656$819-20%144%130297
CPT 36465
Njx noncmpnd sclrsnt 1 vein
$148$185-20%140%130290
CPT 93016
Cv stress test supvj only
$27$34-21%130%130297
CPT 93015
Cv stress test supvj i&r
$94$120-22%127%130299
CPT 93296
Rem interrog evl pm/ids
$30$39-24%94%130296
CPT 93000
Electrocardiogram complete
$19$25-24%126%130301
CPT 93970
Extremity study
$209$275-24%113%130296
CPT 99454
Rem mntr physiol param 16-30
$56$75-25%108%130292
CPT 93280
Pm device progr eval dual
$79$105-25%100%130296
CPT 93880
Extracranial bilat study
$211$283-25%112%130298
CPT 93925
Lower extremity study
$260$349-26%109%130297
CPT 93458
L hrt artery/ventricle angio
$1,149$1,573-27%114%130291
CPT 93308
Tte f-up or lmtd
$112$155-28%110%130295
CPT 93312
Echo transesophageal
$276$387-29%115%130293
CPT 93306
Tte w/doppler complete
$226$317-29%115%130298
CPT 93351
Stress tte complete
$260$366-29%112%130294
CPT 78452
Ht muscle image spect mult
$428$609-30%100%130296
CPT 75574
Ct angio hrt w/3d image
$338$495-32%104%130293

Frequently asked questions

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

Texas ranks 48th of 51 states with an index of 80; 0 of 38 codes are above the national median.

Which cardiology code has the biggest premium in Texas?

CPT 93297 (Rem interrog dev eval icpms), at 100% 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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