Internal medicine · Tennessee

Internal medicine commercial reimbursement in Tennessee

How Tennessee internal medicine rates compare with the national market.

Internal medicine in Tennessee

25 codes · 109 sampled providers
Index vs national
89
11% below
Rank among states
35 of 51
1 = highest
Codes above national
0 of 25
median code at 89%
Providers
109
sampled

What the data shows

1

Internal medicine ranks 35th of 51 states in Tennessee with an index of 89 (100 = the specialty's national median), across 25 codes and 109 sampled providers.

2

Of the 25 internal medicine codes with enough data in Tennessee, 0 pay above the national median and 25 below; the typical code sits at 89% of the national median.

3

Largest premium over the national median: CPT 99487 (Cplx chrnc care 1st 60 min) at 94%; largest discount: CPT 78452 (Ht muscle image spect mult) at 85%.

4

Measured against Medicare, Tennessee internal medicine rates have a median of 107% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeTennesseeNationalGapProv.
99487
Cplx chrnc care 1st 60 min
$114$121-6%104
99215
Office o/p est hi 40 min
$174$188-8%108
99350
Home/res vst est high mdm 60
$227$247-8%105
90960
Esrd srv 4 visits p mo 20+
$415$453-8%104
99349
Home/res vst est mod mdm 40
$159$174-8%105

Lowest vs national

CodeTennesseeNationalGapProv.
78452
Ht muscle image spect mult
$527$621-15%107
45385
Colonoscopy w/lesion removal
$454$535-15%107
93000
Electrocardiogram complete
$22$25-14%107
99212
Office o/p est sf 10 min
$45$52-14%108
99454
Rem mntr physiol param 16-30
$66$76-13%104

All internal medicine codes in Tennessee

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeTennesseeNationalGap% of MedicareProvidersTINsLevel
CPT 99487
Cplx chrnc care 1st 60 min
$114$121-6%79%104204
CPT 99215
Office o/p est hi 40 min
$174$188-8%90%108209
CPT 99350
Home/res vst est high mdm 60
$227$247-8%117%105206
CPT 90960
Esrd srv 4 visits p mo 20+
$415$453-8%111%104203
CPT 99349
Home/res vst est mod mdm 40
$159$174-8%121%105206
CPT 99214
Office o/p est mod 30 min
$122$134-9%90%108210
CPT 96372
Ther/proph/diag inj sc/im
$22$24-9%142%107212
CPT 99497
Advncd care plan 30 min
$99$108-9%114%105205
CPT 99348
Home/res vst est low mdm 30
$98$109-10%125%105206
CPT 99205
Office o/p new hi 60 min
$231$256-10%97%109211
CPT 99204
Office o/p new mod 45 min
$176$196-10%99%109211
CPT 99490
Chrnc care mgmt staff 1st 20
$55$61-10%83%105207
CPT 99496
Transj care mgmt high f2f 7d
$259$291-11%87%105209
CPT 93306
Tte w/doppler complete
$284$319-11%144%107209
CPT 99213
Office o/p est low 20 min
$82$92-11%86%108210
CPT 93880
Extracranial bilat study
$252$285-12%133%107208
CPT 20610
Drain/inj joint/bursa w/o us
$73$83-12%107%107209
CPT 99203
Office o/p new low 30 min
$110$125-12%94%108210
CPT 99495
Transj care mgmt mod f2f 14d
$185$211-13%84%105210
CPT 99457
Rpm tx mgmt 1st 20 min
$46$53-13%89%104206
CPT 99454
Rem mntr physiol param 16-30
$66$76-13%127%104206
CPT 99212
Office o/p est sf 10 min
$45$52-13%75%108209
CPT 93000
Electrocardiogram complete
$22$25-14%141%107208
CPT 45385
Colonoscopy w/lesion removal
$454$535-15%203%107210
CPT 78452
Ht muscle image spect mult
$527$621-15%123%107209

Frequently asked questions

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

Tennessee ranks 35th of 51 states with an index of 89; 0 of 25 codes are above the national median.

Which internal medicine code has the biggest premium in Tennessee?

CPT 99487 (Cplx chrnc care 1st 60 min), at 94% 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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