Internal medicine · Oregon

Internal medicine commercial reimbursement in Oregon

How Oregon internal medicine rates compare with the national market.

Internal medicine in Oregon

25 codes · 99 sampled providers
Index vs national
158
58% above
Rank among states
3 of 51
1 = highest
Codes above national
25 of 25
median code at 158%
Providers
99
sampled

What the data shows

1

Internal medicine ranks 3rd of 51 states in Oregon with an index of 158 (100 = the specialty's national median), across 25 codes and 99 sampled providers.

2

Of the 25 internal medicine codes with enough data in Oregon, 25 pay above the national median and 0 below; the typical code sits at 158% of the national median.

3

Largest premium over the national median: CPT 99487 (Cplx chrnc care 1st 60 min) at 190%; largest discount: CPT 45385 (Colonoscopy w/lesion removal) at 128%.

4

Measured against Medicare, Oregon internal medicine rates have a median of 175% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeOregonNationalGapProv.
99487
Cplx chrnc care 1st 60 min
$231$121+90%98
99490
Chrnc care mgmt staff 1st 20
$115$61+89%98
99349
Home/res vst est mod mdm 40
$292$174+68%98
99350
Home/res vst est high mdm 60
$412$247+67%98
99213
Office o/p est low 20 min
$153$92+66%99

Lowest vs national

CodeOregonNationalGapProv.
45385
Colonoscopy w/lesion removal
$682$535+28%99
93000
Electrocardiogram complete
$33$25+33%99
20610
Drain/inj joint/bursa w/o us
$110$83+33%99
93306
Tte w/doppler complete
$438$319+37%99
96372
Ther/proph/diag inj sc/im
$34$24+40%99

All internal medicine codes in Oregon

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeOregonNationalGap% of MedicareProvidersTINsLevel
CPT 99487
Cplx chrnc care 1st 60 min
$231$121+90%160%98150
CPT 99490
Chrnc care mgmt staff 1st 20
$115$61+89%174%98153
CPT 99349
Home/res vst est mod mdm 40
$292$174+68%221%98155
CPT 99350
Home/res vst est high mdm 60
$412$247+67%213%98155
CPT 99213
Office o/p est low 20 min
$153$92+66%160%99157
CPT 99348
Home/res vst est low mdm 30
$178$109+64%226%98154
CPT 99205
Office o/p new hi 60 min
$415$256+62%175%99156
CPT 99497
Advncd care plan 30 min
$174$108+60%200%98153
CPT 99214
Office o/p est mod 30 min
$214$134+60%158%99157
CPT 99215
Office o/p est hi 40 min
$301$188+60%157%99157
CPT 90960
Esrd srv 4 visits p mo 20+
$722$453+59%194%97147
CPT 99495
Transj care mgmt mod f2f 14d
$333$211+58%151%98155
CPT 99454
Rem mntr physiol param 16-30
$120$76+58%231%98150
CPT 99212
Office o/p est sf 10 min
$81$52+57%137%99157
CPT 99204
Office o/p new mod 45 min
$308$196+57%174%99156
CPT 99457
Rpm tx mgmt 1st 20 min
$81$53+54%157%98150
CPT 99496
Transj care mgmt high f2f 7d
$445$291+53%149%99155
CPT 99203
Office o/p new low 30 min
$190$125+52%162%99157
CPT 78452
Ht muscle image spect mult
$935$621+51%219%99156
CPT 93880
Extracranial bilat study
$414$285+45%219%99157
CPT 96372
Ther/proph/diag inj sc/im
$34$24+40%218%99158
CPT 93306
Tte w/doppler complete
$438$319+37%223%99156
CPT 20610
Drain/inj joint/bursa w/o us
$110$83+33%161%99158
CPT 93000
Electrocardiogram complete
$33$25+33%216%99156
CPT 45385
Colonoscopy w/lesion removal
$682$535+28%305%99156

Frequently asked questions

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

Oregon ranks 3rd of 51 states with an index of 158; 25 of 25 codes are above the national median.

Which internal medicine code has the biggest premium in Oregon?

CPT 99487 (Cplx chrnc care 1st 60 min), at 190% 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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