Commercial healthcare reimbursement in Georgia
How Georgia compares with the nation, by payer, specialty and procedure.
Georgia at a glance
What the data shows
Georgia ranks 11th of 51 states for commercial reimbursement, with an index of 125 (100 = national median) across 228 procedure codes; the South region averages 94.
Commercial rates in Georgia run a median 188% of Medicare.
UnitedHealthcare has the highest index in the state (115) and Aetna the lowest (83), a 32-point gap, in the files analyzed.
CPT 93229 (Remote 30 day ecg tech supp) is the strongest relative to the national median (157% of it, a 57% premium); CPT 96372 (Ther/proph/diag inj sc/im) is furthest below (92% of the national median, 8% lower).
By specialty, Georgia is strongest for cardiology (ranks 6th of 51 states for that specialty) and weakest for orthopedic surgery (15th of 51).
Against Medicare, gastroenterology has the highest ratio in Georgia (241% of Medicare) and dermatology the lowest (130%).
Payer ranking in Georgia
| Payer | Index | Rank | Level | Codes | Providers | TINs |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 115 | 1 | 228 | 780 | 528 | |
| Cigna | 105 | 2 | 228 | 829 | 527 | |
| Blue Cross Blue Shield | 98 | 3 | 228 | 944 | 881 | |
| Aetna | 83 | 4 | 228 | 755 | 605 |
Reimbursement index by specialty in Georgia
| Specialty | Index | Rank among states | % of Medicare | Level | Codes | Providers |
|---|---|---|---|---|---|---|
| Cardiology | 138 | 6 of 51 | 214% | 38 | 129 | |
| Internal medicine | 122 | 9 of 51 | 141% | 25 | 121 | |
| Ophthalmology | 132 | 9 of 50 | 156% | 42 | 115 | |
| Gastroenterology | 121 | 10 of 50 | 241% | 36 | 127 | |
| Urology | 118 | 11 of 50 | 181% | 37 | 118 | |
| Dermatology | 136 | 12 of 50 | 130% | 44 | 116 | |
| Diagnostic radiology | 113 | 12 of 51 | 177% | 49 | 128 | |
| Orthopedic surgery | 113 | 15 of 51 | 159% | 39 | 124 |
Specialty by payer in Georgia
| Specialty | UHC | Aetna | Cigna | BCBS |
|---|---|---|---|---|
| Internal medicine | 154 | 82 | 119 | 129 |
| Dermatology | 175 | 105 | 146 | 133 |
| Ophthalmology | 160 | 111 | 149 | 126 |
| Cardiology | 162 | 108 | 147 | 132 |
| Orthopedic surgery | 121 | 113 | 118 | 100 |
| Diagnostic radiology | 153 | 79 | 160 | 108 |
| Urology | 127 | 103 | 114 | 112 |
| Gastroenterology | 113 | 111 | 102 | 129 |
Georgia compared with South region states
| State | Index | Rank | % of Medicare | Providers | Level |
|---|---|---|---|---|---|
| Georgia | 125 | 11 | 188% | 978 | |
| North Carolina | 115 | 15 | 175% | 1,009 | |
| Mississippi | 111 | 16 | 159% | 778 | |
| District of Columbia | 104 | 20 | 154% | 521 | |
| Tennessee | 96 | 29 | 143% | 944 | |
| West Virginia | 93 | 34 | 146% | 608 |
Procedures that pay most and least in Georgia vs the nation
Highest vs national
| Code | Georgia | National | Gap | Prov. |
|---|---|---|---|---|
| 93229 Remote 30 day ecg tech supp | $1,712 | $1,088 | +57% | 128 |
| 92242 Fluorescein&icg angiography | $449 | $288 | +56% | 113 |
| 77280 Ther rad simulaj field smpl | $467 | $302 | +55% | 114 |
| 96910 Photchmtx tar&uvb/ptrltm&uvb | $194 | $125 | +55% | 116 |
| 93351 Stress tte complete | $561 | $366 | +53% | 128 |
| 93458 L hrt artery/ventricle angio | $2,403 | $1,573 | +53% | 129 |
| 33361 Replace aortic valve perq | $2,958 | $1,938 | +53% | 128 |
| 93308 Tte f-up or lmtd | $236 | $155 | +52% | 129 |
| 14060 Tis trnfr e/n/e/l 10 sq cm/< | $1,257 | $835 | +51% | 116 |
| 17000 Destruct premalg lesion | $103 | $69 | +48% | 116 |
| 15260 Fth/gft fr n/e/e/l 20 sqcm/< | $1,597 | $1,078 | +48% | 115 |
| 14040 Tis trnfr f/c/c/m/n/a/g/h/f | $1,181 | $800 | +48% | 115 |
| 93016 Cv stress test supvj only | $50 | $34 | +47% | 129 |
| 75574 Ct angio hrt w/3d image | $723 | $495 | +46% | 129 |
| 93312 Echo transesophageal | $564 | $387 | +46% | 129 |
Lowest vs national
| Code | Georgia | National | Gap | Prov. |
|---|---|---|---|---|
| 96372 Ther/proph/diag inj sc/im | $22 | $24 | -8% | 120 |
| 88313 Special stains group 2 | $67 | $71 | -5% | 124 |
| 71045 X-ray exam chest 1 view | $31 | $33 | -4% | 128 |
| 74174 Cta abd&plvs w/contrast | $601 | $601 | +0% | 128 |
| 88312 Special stains group 1 | $99 | $97 | +2% | 237 |
| 88305 Tissue exam by pathologist | $71 | $70 | +2% | 237 |
| 74177 Ct abd & pelvis w/contrast | $464 | $448 | +3% | 128 |
| 51729 Cystometrogram w/vp&up | $580 | $554 | +5% | 118 |
| 76872 Us transrectal | $197 | $188 | +5% | 118 |
| 77067 Scr mammo bi incl cad | $191 | $182 | +5% | 128 |
| 77066 Dx mammo incl cad bi | $237 | $225 | +5% | 128 |
| 76642 Ultrasound breast limited | $126 | $120 | +5% | 127 |
| 73502 X-ray exam hip uni 2-3 views | $64 | $61 | +5% | 251 |
| 45380 Colonoscopy and biopsy | $495 | $470 | +5% | 127 |
| 77065 Dx mammo incl cad uni | $189 | $179 | +6% | 127 |
Frequently asked questions
How do commercial reimbursement rates in Georgia compare with the rest of the country?
Georgia ranks 11th of 51 states with an index of 125, across 228 procedure codes. Median commercial rates run 188% of the Medicare rate.
Which payer has the highest rates in Georgia?
In the files we analyzed, UnitedHealthcare has the highest index (115) and Aetna the lowest (83). Each payer's figures describe the specific plans and networks in the files used, not its whole book of business.
Which specialty has the strongest rates in Georgia?
Cardiology ranks 6th of 51 states.
How many providers does this Georgia page cover?
978 sampled providers across 4 payers. The data comes from a random sample of providers, so counts describe the sample, not every provider in the state.
Which procedures differ most between Georgia and the national median?
CPT 93229 (Remote 30 day ecg tech supp) is highest relative to the nation at 157% of the national median; CPT 96372 (Ther/proph/diag inj sc/im) is lowest at 92%.
Methodology
- 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.
Benchmark your Georgia contracts
Compare your negotiated rates with these state medians by payer and specialty.