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National Reimbursement Benchmarks
Medicare’s mean rate for CPT 93922 sits at $57.8, substantially below BUCA’s average commercial mean of $157.3 — a difference of $99.5, reflecting a sizable gap between public and average commercial reimbursement. This gap highlights the divergence between Medicare’s baseline and commercial contractual levels, with BUCA closer to many commercial payers’ means and medians.
Dispersion measured by the interquartile range (P75 minus P25) is widest for Blue Cross Blue Shield at $95.1 (P75 $241.9 minus P25 $146.8) and also relatively wide for Aetna at $77.5 and UnitedHealth Group at $103.0. The tightest spread appears for Cigna at $109.5? Wait — recalculating shows Cigna’s P75 $136.0 minus P25 $26.0 equals $110.0, which is larger; therefore the smallest IQR among listed payers is Aetna at $77.5, indicating more concentrated commercial rates versus others.