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For some Icom radios (eg, the ID-880H and IC-2820H) that use the Icom OPC-1529R cable, it's a simple three-wire cable providing ground, TX, and RX. Presumably these are at RS-232C acceptable levels (that's a whole different discussion). Other cables (eg, the Yaesu one for the Yaesu FT-897D) have a little circuit board in the RS-232C/DB-9 shell that does level conversion (and needs power, except for the few radios where the cable provides the power). Still other cables, like the ones that split out TX and RX signals from a single wire, have additional circuitry for that purpose.