Cardiology · Washington

Cardiology commercial reimbursement in Washington

How Washington cardiology rates compare with the national market.

Cardiology in Washington

38 codes · 110 sampled providers
Index vs national
139
39% above
Rank among states
5 of 51
1 = highest
Codes above national
38 of 38
median code at 140%
Providers
110
sampled

What the data shows

1

Cardiology ranks 5th of 51 states in Washington with an index of 139 (100 = the specialty's national median), across 38 codes and 110 sampled providers.

2

Of the 38 cardiology codes with enough data in Washington, 38 pay above the national median and 0 below; the typical code sits at 140% of the national median.

3

Largest premium over the national median: CPT 99490 (Chrnc care mgmt staff 1st 20) at 164%; largest discount: CPT 20610 (Drain/inj joint/bursa w/o us) at 124%.

4

Measured against Medicare, Washington cardiology rates have a median of 210% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeWashingtonNationalGapProv.
99490
Chrnc care mgmt staff 1st 20
$98$60+64%108
99212
Office o/p est sf 10 min
$83$51+63%110
93297
Rem interrog dev eval icpms
$83$52+58%109
99215
Office o/p est hi 40 min
$291$185+58%110
99203
Office o/p new low 30 min
$189$122+55%110

Lowest vs national

CodeWashingtonNationalGapProv.
20610
Drain/inj joint/bursa w/o us
$103$83+24%109
93000
Electrocardiogram complete
$32$25+26%110
93656
Compre ep eval abltj atr fib
$2,039$1,615+26%110
33361
Replace aortic valve perq
$2,450$1,938+26%110
93015
Cv stress test supvj i&r
$152$120+26%110

All cardiology codes in Washington

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeWashingtonNationalGap% of MedicareProvidersTINsLevel
CPT 99490
Chrnc care mgmt staff 1st 20
$98$60+64%148%108218
CPT 99212
Office o/p est sf 10 min
$83$51+63%140%110225
CPT 93297
Rem interrog dev eval icpms
$83$52+58%136%109221
CPT 99215
Office o/p est hi 40 min
$291$185+58%151%110225
CPT 99203
Office o/p new low 30 min
$189$122+55%161%110225
CPT 99214
Office o/p est mod 30 min
$202$131+55%149%110225
CPT 93280
Pm device progr eval dual
$162$105+54%207%110226
CPT 99213
Office o/p est low 20 min
$139$91+53%146%110225
CPT 99205
Office o/p new hi 60 min
$379$250+52%160%110226
CPT 78452
Ht muscle image spect mult
$921$609+51%215%110228
CPT 93229
Remote 30 day ecg tech supp
$1,635$1,088+50%216%107216
CPT 93925
Lower extremity study
$522$349+50%220%109228
CPT 99204
Office o/p new mod 45 min
$285$192+49%161%110226
CPT 93880
Extracranial bilat study
$420$283+48%222%110228
CPT 93970
Extremity study
$404$275+47%219%109228
CPT 93458
L hrt artery/ventricle angio
$2,265$1,573+44%224%110223
CPT 99454
Rem mntr physiol param 16-30
$106$75+42%204%109222
CPT 93308
Tte f-up or lmtd
$218$155+41%215%110225
CPT 93351
Stress tte complete
$513$366+40%220%110225
CPT 99457
Rpm tx mgmt 1st 20 min
$73$53+39%141%109221
CPT 93298
Rem interrog dev eval scrms
$72$52+37%70%110226
CPT 93306
Tte w/doppler complete
$434$317+37%221%110227
CPT 93010
Electrocardiogram report
$17$13+35%204%110225
CPT 93312
Echo transesophageal
$520$387+34%217%110224
CPT 92928
Prq tcat plmt ntrac st 1 les
$1,181$887+33%255%110224
CPT 33285
Insj subq car rhythm mntr
$180$135+33%237%108220
CPT 36482
Endoven ther chem adhes 1st
$363$278+31%229%107213
CPT 36465
Njx noncmpnd sclrsnt 1 vein
$241$185+30%228%107211
CPT 93016
Cv stress test supvj only
$44$34+30%213%110223
CPT 33208
Insrt heart pm atrial & vent
$1,063$819+30%233%110224
CPT 75574
Ct angio hrt w/3d image
$642$495+30%197%110225
CPT 93296
Rem interrog evl pm/ids
$50$39+29%158%110224
CPT 93294
Rem interrog evl pm/ldls pm
$62$48+29%210%110225
CPT 93015
Cv stress test supvj i&r
$152$120+27%207%110225
CPT 33361
Replace aortic valve perq
$2,450$1,938+26%227%110226
CPT 93656
Compre ep eval abltj atr fib
$2,039$1,615+26%253%110223
CPT 93000
Electrocardiogram complete
$32$25+26%208%110227
CPT 20610
Drain/inj joint/bursa w/o us
$103$83+24%150%109224

Frequently asked questions

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

Washington ranks 5th of 51 states with an index of 139; 38 of 38 codes are above the national median.

Which cardiology code has the biggest premium in Washington?

CPT 99490 (Chrnc care mgmt staff 1st 20), at 164% 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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