Internal medicine · Missouri

Internal medicine commercial reimbursement in Missouri

How Missouri internal medicine rates compare with the national market.

Internal medicine in Missouri

25 codes · 114 sampled providers
Index vs national
89
11% below
Rank among states
36 of 51
1 = highest
Codes above national
3 of 25
median code at 89%
Providers
114
sampled

What the data shows

1

Internal medicine ranks 36th of 51 states in Missouri with an index of 89 (100 = the specialty's national median), across 25 codes and 114 sampled providers.

2

Of the 25 internal medicine codes with enough data in Missouri, 3 pay above the national median and 22 below; the typical code sits at 89% of the national median.

3

Largest premium over the national median: CPT 93880 (Extracranial bilat study) at 102%; largest discount: CPT 99490 (Chrnc care mgmt staff 1st 20) at 81%.

4

Measured against Medicare, Missouri internal medicine rates have a median of 110% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMissouriNationalGapProv.
93880
Extracranial bilat study
$291$285+2%114
93306
Tte w/doppler complete
$323$319+1%114
93000
Electrocardiogram complete
$25$25+1%114
45385
Colonoscopy w/lesion removal
$508$535-5%114
20610
Drain/inj joint/bursa w/o us
$79$83-5%114

Lowest vs national

CodeMissouriNationalGapProv.
99490
Chrnc care mgmt staff 1st 20
$49$61-19%113
99215
Office o/p est hi 40 min
$161$188-14%114
99213
Office o/p est low 20 min
$79$92-14%114
99214
Office o/p est mod 30 min
$115$134-14%114
99350
Home/res vst est high mdm 60
$213$247-14%114

All internal medicine codes in Missouri

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMissouriNationalGap% of MedicareProvidersTINsLevel
CPT 93880
Extracranial bilat study
$291$285+2%154%114244
CPT 93306
Tte w/doppler complete
$323$319+1%164%114246
CPT 93000
Electrocardiogram complete
$25$25+1%165%114246
CPT 45385
Colonoscopy w/lesion removal
$508$535-5%227%114244
CPT 20610
Drain/inj joint/bursa w/o us
$79$83-5%114%114247
CPT 99454
Rem mntr physiol param 16-30
$71$76-7%137%114244
CPT 96372
Ther/proph/diag inj sc/im
$22$24-7%146%114247
CPT 90960
Esrd srv 4 visits p mo 20+
$420$453-7%113%114242
CPT 78452
Ht muscle image spect mult
$569$621-8%133%114245
CPT 99497
Advncd care plan 30 min
$99$108-8%115%113240
CPT 99348
Home/res vst est low mdm 30
$100$109-8%126%114243
CPT 99204
Office o/p new mod 45 min
$175$196-11%99%114247
CPT 99457
Rpm tx mgmt 1st 20 min
$47$53-11%91%114244
CPT 99203
Office o/p new low 30 min
$111$125-11%94%114246
CPT 99495
Transj care mgmt mod f2f 14d
$186$211-12%84%113243
CPT 99349
Home/res vst est mod mdm 40
$153$174-12%115%114243
CPT 99212
Office o/p est sf 10 min
$45$52-12%76%114246
CPT 99205
Office o/p new hi 60 min
$224$256-13%95%114246
CPT 99487
Cplx chrnc care 1st 60 min
$106$121-13%73%113240
CPT 99496
Transj care mgmt high f2f 7d
$253$291-13%85%113247
CPT 99350
Home/res vst est high mdm 60
$213$247-14%110%114241
CPT 99214
Office o/p est mod 30 min
$115$134-14%85%114249
CPT 99213
Office o/p est low 20 min
$79$92-14%83%114250
CPT 99215
Office o/p est hi 40 min
$161$188-14%84%114246
CPT 99490
Chrnc care mgmt staff 1st 20
$49$61-19%75%113238

Frequently asked questions

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

Missouri ranks 36th of 51 states with an index of 89; 3 of 25 codes are above the national median.

Which internal medicine code has the biggest premium in Missouri?

CPT 93880 (Extracranial bilat study), at 102% 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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