Internal medicine · Iowa

Internal medicine commercial reimbursement in Iowa

How Iowa internal medicine rates compare with the national market.

Internal medicine in Iowa

25 codes · 100 sampled providers
Index vs national
105
5% above
Rank among states
22 of 51
1 = highest
Codes above national
17 of 25
median code at 105%
Providers
100
sampled

What the data shows

1

Internal medicine ranks 22nd of 51 states in Iowa with an index of 105 (100 = the specialty's national median), across 25 codes and 100 sampled providers.

2

Of the 25 internal medicine codes with enough data in Iowa, 17 pay above the national median and 8 below; the typical code sits at 105% of the national median.

3

Largest premium over the national median: CPT 90960 (Esrd srv 4 visits p mo 20+) at 146%; largest discount: CPT 99454 (Rem mntr physiol param 16-30) at 94%.

4

Measured against Medicare, Iowa internal medicine rates have a median of 123% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeIowaNationalGapProv.
90960
Esrd srv 4 visits p mo 20+
$661$453+46%99
93306
Tte w/doppler complete
$393$319+23%99
93000
Electrocardiogram complete
$31$25+22%99
93880
Extracranial bilat study
$346$285+21%99
78452
Ht muscle image spect mult
$752$621+21%99

Lowest vs national

CodeIowaNationalGapProv.
99454
Rem mntr physiol param 16-30
$71$76-6%99
99203
Office o/p new low 30 min
$122$125-2%99
99497
Advncd care plan 30 min
$107$108-2%99
99204
Office o/p new mod 45 min
$194$196-1%99
99496
Transj care mgmt high f2f 7d
$287$291-1%99

All internal medicine codes in Iowa

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeIowaNationalGap% of MedicareProvidersTINsLevel
CPT 90960
Esrd srv 4 visits p mo 20+
$661$453+46%177%99167
CPT 93306
Tte w/doppler complete
$393$319+23%200%99169
CPT 93000
Electrocardiogram complete
$31$25+22%200%99170
CPT 93880
Extracranial bilat study
$346$285+21%183%99169
CPT 78452
Ht muscle image spect mult
$752$621+21%176%99169
CPT 20610
Drain/inj joint/bursa w/o us
$99$83+19%144%100169
CPT 96372
Ther/proph/diag inj sc/im
$28$24+18%184%99170
CPT 99490
Chrnc care mgmt staff 1st 20
$69$61+13%105%99166
CPT 99215
Office o/p est hi 40 min
$208$188+11%108%99171
CPT 99350
Home/res vst est high mdm 60
$267$247+8%138%99168
CPT 99487
Cplx chrnc care 1st 60 min
$131$121+7%90%99167
CPT 99349
Home/res vst est mod mdm 40
$184$174+6%139%99168
CPT 99214
Office o/p est mod 30 min
$141$134+5%104%99171
CPT 99213
Office o/p est low 20 min
$96$92+4%100%99171
CPT 99205
Office o/p new hi 60 min
$263$256+3%111%99170
CPT 45385
Colonoscopy w/lesion removal
$549$535+3%246%99169
CPT 99348
Home/res vst est low mdm 30
$111$109+2%141%99168
CPT 99495
Transj care mgmt mod f2f 14d
$211$211+0%96%99169
CPT 99457
Rpm tx mgmt 1st 20 min
$53$53-0%102%99168
CPT 99212
Office o/p est sf 10 min
$51$52-1%86%99171
CPT 99496
Transj care mgmt high f2f 7d
$287$291-1%96%99168
CPT 99204
Office o/p new mod 45 min
$194$196-1%109%99171
CPT 99497
Advncd care plan 30 min
$107$108-2%123%99169
CPT 99203
Office o/p new low 30 min
$122$125-2%104%99171
CPT 99454
Rem mntr physiol param 16-30
$71$76-6%137%99168

Frequently asked questions

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

Iowa ranks 22nd of 51 states with an index of 105; 17 of 25 codes are above the national median.

Which internal medicine code has the biggest premium in Iowa?

CPT 90960 (Esrd srv 4 visits p mo 20+), at 146% 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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