Internal medicine · North Dakota

Internal medicine commercial reimbursement in North Dakota

How North Dakota internal medicine rates compare with the national market.

Internal medicine in North Dakota

25 codes · 108 sampled providers
Index vs national
132
32% above
Rank among states
8 of 51
1 = highest
Codes above national
25 of 25
median code at 132%
Providers
108
sampled

What the data shows

1

Internal medicine ranks 8th of 51 states in North Dakota with an index of 132 (100 = the specialty's national median), across 25 codes and 108 sampled providers.

2

Of the 25 internal medicine codes with enough data in North Dakota, 25 pay above the national median and 0 below; the typical code sits at 132% of the national median.

3

Largest premium over the national median: CPT 99487 (Cplx chrnc care 1st 60 min) at 168%; largest discount: CPT 99213 (Office o/p est low 20 min) at 115%.

4

Measured against Medicare, North Dakota internal medicine rates have a median of 159% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeNorth DakoNationalGapProv.
99487
Cplx chrnc care 1st 60 min
$204$121+68%105
99490
Chrnc care mgmt staff 1st 20
$93$61+52%108
99350
Home/res vst est high mdm 60
$372$247+51%105
99495
Transj care mgmt mod f2f 14d
$314$211+49%108
99349
Home/res vst est mod mdm 40
$256$174+47%105

Lowest vs national

CodeNorth DakoNationalGapProv.
99213
Office o/p est low 20 min
$106$92+16%94
99215
Office o/p est hi 40 min
$219$188+16%94
99203
Office o/p new low 30 min
$146$125+17%94
99214
Office o/p est mod 30 min
$157$134+18%94
45385
Colonoscopy w/lesion removal
$637$535+19%108

All internal medicine codes in North Dakota

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNorth DakotaNationalGap% of MedicareProvidersTINsLevel
CPT 99487
Cplx chrnc care 1st 60 min
$204$121+68%142%105190
CPT 99490
Chrnc care mgmt staff 1st 20
$93$61+52%140%108191
CPT 99350
Home/res vst est high mdm 60
$372$247+51%193%105192
CPT 99495
Transj care mgmt mod f2f 14d
$314$211+49%143%108191
CPT 99349
Home/res vst est mod mdm 40
$256$174+47%193%105192
CPT 90960
Esrd srv 4 visits p mo 20+
$655$453+45%176%105189
CPT 99348
Home/res vst est low mdm 30
$157$109+44%199%105192
CPT 99497
Advncd care plan 30 min
$153$108+41%176%108189
CPT 99457
Rpm tx mgmt 1st 20 min
$73$53+38%142%105191
CPT 99496
Transj care mgmt high f2f 7d
$394$291+36%132%108194
CPT 78452
Ht muscle image spect mult
$838$621+35%196%108188
CPT 93880
Extracranial bilat study
$380$285+33%201%108190
CPT 96372
Ther/proph/diag inj sc/im
$32$24+32%207%108194
CPT 20610
Drain/inj joint/bursa w/o us
$109$83+31%159%108193
CPT 99454
Rem mntr physiol param 16-30
$97$76+28%187%105191
CPT 93000
Electrocardiogram complete
$31$25+24%202%107178
CPT 99205
Office o/p new hi 60 min
$317$256+24%134%94167
CPT 99204
Office o/p new mod 45 min
$242$196+23%136%94167
CPT 93306
Tte w/doppler complete
$393$319+23%200%108190
CPT 99212
Office o/p est sf 10 min
$63$52+21%105%94167
CPT 45385
Colonoscopy w/lesion removal
$637$535+19%285%108190
CPT 99214
Office o/p est mod 30 min
$157$134+18%116%94166
CPT 99203
Office o/p new low 30 min
$146$125+17%124%94167
CPT 99215
Office o/p est hi 40 min
$219$188+16%114%94166
CPT 99213
Office o/p est low 20 min
$106$92+15%112%94167

Frequently asked questions

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

North Dakota ranks 8th of 51 states with an index of 132; 25 of 25 codes are above the national median.

Which internal medicine code has the biggest premium in North Dakota?

CPT 99487 (Cplx chrnc care 1st 60 min), at 168% 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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