Internal medicine · Florida

Internal medicine commercial reimbursement in Florida

How Florida internal medicine rates compare with the national market.

Internal medicine in Florida

25 codes · 105 sampled providers
Index vs national
75
25% below
Rank among states
48 of 51
1 = highest
Codes above national
0 of 25
median code at 75%
Providers
105
sampled

What the data shows

1

Internal medicine ranks 48th of 51 states in Florida with an index of 75 (100 = the specialty's national median), across 25 codes and 105 sampled providers.

2

Of the 25 internal medicine codes with enough data in Florida, 0 pay above the national median and 25 below; the typical code sits at 75% of the national median.

3

Largest premium over the national median: CPT 96372 (Ther/proph/diag inj sc/im) at 82%; largest discount: CPT 78452 (Ht muscle image spect mult) at 62%.

4

Measured against Medicare, Florida internal medicine rates have a median of 89% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeFloridaNationalGapProv.
96372
Ther/proph/diag inj sc/im
$20$24-18%104
99457
Rpm tx mgmt 1st 20 min
$43$53-19%102
99203
Office o/p new low 30 min
$101$125-19%105
99205
Office o/p new hi 60 min
$204$256-20%105
99204
Office o/p new mod 45 min
$155$196-21%105

Lowest vs national

CodeFloridaNationalGapProv.
78452
Ht muscle image spect mult
$382$621-38%103
93000
Electrocardiogram complete
$18$25-30%104
99349
Home/res vst est mod mdm 40
$127$174-27%102
99350
Home/res vst est high mdm 60
$181$247-27%102
99348
Home/res vst est low mdm 30
$80$109-27%102

All internal medicine codes in Florida

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeFloridaNationalGap% of MedicareProvidersTINsLevel
CPT 96372
Ther/proph/diag inj sc/im
$20$24-18%127%104187
CPT 99457
Rpm tx mgmt 1st 20 min
$43$53-19%83%102184
CPT 99203
Office o/p new low 30 min
$101$125-19%86%105185
CPT 99205
Office o/p new hi 60 min
$204$256-21%86%105186
CPT 99204
Office o/p new mod 45 min
$155$196-21%87%105185
CPT 99212
Office o/p est sf 10 min
$40$52-22%68%105184
CPT 99215
Office o/p est hi 40 min
$145$188-23%75%105185
CPT 99496
Transj care mgmt high f2f 7d
$224$291-23%75%103185
CPT 90960
Esrd srv 4 visits p mo 20+
$347$453-23%93%102180
CPT 99214
Office o/p est mod 30 min
$102$134-24%75%105185
CPT 45385
Colonoscopy w/lesion removal
$405$535-24%181%101181
CPT 93880
Extracranial bilat study
$216$285-24%114%102184
CPT 99497
Advncd care plan 30 min
$82$108-25%94%102184
CPT 99495
Transj care mgmt mod f2f 14d
$159$211-25%72%102184
CPT 99454
Rem mntr physiol param 16-30
$57$76-25%110%102183
CPT 99213
Office o/p est low 20 min
$69$92-25%73%105185
CPT 99490
Chrnc care mgmt staff 1st 20
$46$61-25%69%103183
CPT 20610
Drain/inj joint/bursa w/o us
$62$83-25%90%103184
CPT 99487
Cplx chrnc care 1st 60 min
$89$121-26%62%102180
CPT 93306
Tte w/doppler complete
$234$319-27%119%103184
CPT 99348
Home/res vst est low mdm 30
$80$109-27%101%102180
CPT 99350
Home/res vst est high mdm 60
$181$247-27%94%102180
CPT 99349
Home/res vst est mod mdm 40
$127$174-27%96%102181
CPT 93000
Electrocardiogram complete
$18$25-29%115%104187
CPT 78452
Ht muscle image spect mult
$382$621-38%89%103184

Frequently asked questions

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

Florida ranks 48th of 51 states with an index of 75; 0 of 25 codes are above the national median.

Which internal medicine code has the biggest premium in Florida?

CPT 96372 (Ther/proph/diag inj sc/im), at 82% 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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