Internal medicine · Arizona

Internal medicine commercial reimbursement in Arizona

How Arizona internal medicine rates compare with the national market.

Internal medicine in Arizona

25 codes · 96 sampled providers
Index vs national
70
30% below
Rank among states
50 of 51
1 = highest
Codes above national
0 of 25
median code at 70%
Providers
96
sampled

What the data shows

1

Internal medicine ranks 50th of 51 states in Arizona with an index of 70 (100 = the specialty's national median), across 25 codes and 96 sampled providers.

2

Of the 25 internal medicine codes with enough data in Arizona, 0 pay above the national median and 25 below; the typical code sits at 70% of the national median.

3

Largest premium over the national median: CPT 99495 (Transj care mgmt mod f2f 14d) at 80%; largest discount: CPT 96372 (Ther/proph/diag inj sc/im) at 62%.

4

Measured against Medicare, Arizona internal medicine rates have a median of 86% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeArizonaNationalGapProv.
99495
Transj care mgmt mod f2f 14d
$169$211-20%95
99457
Rpm tx mgmt 1st 20 min
$42$53-21%95
99496
Transj care mgmt high f2f 7d
$227$291-22%95
45385
Colonoscopy w/lesion removal
$418$535-22%95
78452
Ht muscle image spect mult
$479$621-23%95

Lowest vs national

CodeArizonaNationalGapProv.
96372
Ther/proph/diag inj sc/im
$15$24-38%96
99213
Office o/p est low 20 min
$60$92-35%96
93000
Electrocardiogram complete
$16$25-35%96
99349
Home/res vst est mod mdm 40
$114$174-35%95
93306
Tte w/doppler complete
$211$319-34%95

All internal medicine codes in Arizona

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeArizonaNationalGap% of MedicareProvidersTINsLevel
CPT 99495
Transj care mgmt mod f2f 14d
$169$211-20%77%95205
CPT 99457
Rpm tx mgmt 1st 20 min
$42$53-21%81%95205
CPT 99496
Transj care mgmt high f2f 7d
$227$291-22%76%95205
CPT 45385
Colonoscopy w/lesion removal
$418$535-22%187%95202
CPT 78452
Ht muscle image spect mult
$479$621-23%112%95201
CPT 90960
Esrd srv 4 visits p mo 20+
$347$453-23%93%95202
CPT 99454
Rem mntr physiol param 16-30
$57$76-25%110%95205
CPT 20610
Drain/inj joint/bursa w/o us
$61$83-27%89%96207
CPT 99490
Chrnc care mgmt staff 1st 20
$44$61-28%66%95205
CPT 99203
Office o/p new low 30 min
$89$125-29%76%96208
CPT 99214
Office o/p est mod 30 min
$95$134-29%70%96212
CPT 99497
Advncd care plan 30 min
$76$108-30%88%96203
CPT 99212
Office o/p est sf 10 min
$36$52-30%61%96208
CPT 99487
Cplx chrnc care 1st 60 min
$84$121-30%59%95204
CPT 99204
Office o/p new mod 45 min
$135$196-31%76%96210
CPT 93880
Extracranial bilat study
$196$285-31%104%95204
CPT 99348
Home/res vst est low mdm 30
$74$109-32%94%95202
CPT 99215
Office o/p est hi 40 min
$127$188-33%66%96209
CPT 99205
Office o/p new hi 60 min
$173$256-33%73%96211
CPT 99350
Home/res vst est high mdm 60
$166$247-33%86%95205
CPT 93306
Tte w/doppler complete
$211$319-34%107%95206
CPT 99349
Home/res vst est mod mdm 40
$114$174-35%86%95205
CPT 93000
Electrocardiogram complete
$16$25-35%106%96204
CPT 99213
Office o/p est low 20 min
$60$92-35%63%96208
CPT 96372
Ther/proph/diag inj sc/im
$15$24-38%97%96207

Frequently asked questions

How do Arizona internal medicine rates compare with the rest of the country?

Arizona ranks 50th of 51 states with an index of 70; 0 of 25 codes are above the national median.

Which internal medicine code has the biggest premium in Arizona?

CPT 99495 (Transj care mgmt mod f2f 14d), at 80% 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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