Internal medicine · specialty benchmark

Internal medicine commercial reimbursement benchmarks

What commercial payers pay for the procedures that matter most to internal medicine practices.

Internal medicine at a glance

5,516 sampled providers

Codes tracked

publishable codes

Median % of Medicare

121%

across codes

Highest state

Alaska

Highest payer

UHC

UnitedHealthcare

Internal medicine rates in this dataset cover 25 procedure codes and 5,516 sampled providers in 51 states, at a median 121% of Medicare.

Alaska has the highest internal medicine index and Alabama the lowest.

UnitedHealthcare has the highest internal medicine index and Aetna the lowest.

The biggest revenue code by Medicare allowed dollars is CPT 99214 (Office o/p est mod 30 min), paid at a 134-dollar median, 99% of Medicare.

Ranked by Medicare allowed dollars billed by the specialty

Rank	Code	Median	Medicare	% of Medicare	Providers
1	CPT 99214 Office o/p est mod 30 min	$134	$135.61	99%	5,471
4	CPT 99213 Office o/p est low 20 min	$92	$95.19	97%	5,472
7	CPT 99215 Office o/p est hi 40 min	$188	$192.39	98%	5,469
11	CPT 99490 Chrnc care mgmt staff 1st 20	$61	$66.13	92%	5,417
14	CPT 99204 Office o/p new mod 45 min	$196	$177.36	111%	5,476
15	CPT 99497 Advncd care plan 30 min	$108	$86.84	125%	5,418
17	CPT 99349 Home/res vst est mod mdm 40	$174	$132.27	132%	5,435
18	CPT 99496 Transj care mgmt high f2f 7d	$291	$298.60	97%	5,461
20	CPT 93306 Tte w/doppler complete	$319	$196.73	162%	5,448
21	CPT 90960 Esrd srv 4 visits p mo 20+	$453	$372.75	121%	5,416

Index: 100 = four-payer median for the specialty's codes

Payer	Index	Rank	Highest on
UnitedHealthcare	119	1	88%
Cigna	104	2	8%
Blue Cross Blue Shield	100	3	4%
Aetna	73	4	0%

Index: 100 = the specialty's national median

Rank	State	Index	Codes	Providers
1	Alaska	182	25	97
2	Wisconsin	172	25	106
3	Oregon	158	25	99
4	Minnesota	156	25	112
5	Washington	150	25	110
6	Nebraska	138	25	89
7	Massachusetts	135	25	121
8	North Dakota	132	25	108
9	Georgia	122	25	121
10	New Hampshire	122	25	110
11	District of Columbia	120	25	84
12	Wyoming	118	25	106
13	North Carolina	117	25	124
14	South Dakota	116	25	123
15	Connecticut	116	25	119
16	Colorado	110	25	115
17	Hawaii	109	25	79
18	Vermont	108	25	117
19	Idaho	108	25	109
20	Maine	107	25	120
21	Montana	106	25	103
22	Iowa	105	25	100
23	Pennsylvania	100	25	108
24	New Mexico	100	25	106
25	California	99	25	97
26	New Jersey	99	25	114
27	Utah	96	25	107
28	South Carolina	96	25	102
29	Ohio	96	25	120
30	Kansas	94	25	110
31	Illinois	94	25	89
32	New York	94	25	115
33	Oklahoma	92	25	109
34	Rhode Island	91	25	98
35	Tennessee	89	25	109
36	Missouri	89	25	114
37	Arkansas	88	25	121
38	West Virginia	86	25	114
39	Virginia	86	25	99
40	Indiana	85	25	123
41	Kentucky	85	25	127
42	Michigan	83	25	106
43	Louisiana	83	25	114
44	Delaware	80	25	108
45	Maryland	80	25	94
46	Texas	80	25	122
47	Mississippi	78	25	101
48	Florida	75	25	105
49	Nevada	74	25	111
50	Arizona	70	25	96
51	Alabama	66	25	105

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.

See how your negotiated rates compare by code, payer and state.