This provider's $4.8M in total Medicare payments ranks in the 98th percentile of Cardiology providers nationally.
Medicare payments to this provider grew 639% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 212% in 2023
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $694.19 | $151.66 | 4.58x | $542.53 | $217.5K | 2.5K | 1.9K |
| 2015 | $538.10 | $131.67 | 4.09x | $406.43 | $343.2K | 3.2K | 2.4K |
| 2016 | $521.01 | $126.04 | 4.13x | $394.97 | $334.0K | 3.5K | 2.5K |
| 2017 | $530.16 | $130.32 | 4.07x | $399.84 | $322.4K | 3.3K | 2.3K |
| 2018 | $481.77 | $112.71 | 4.27x | $369.06 | $374.4K | 3.8K | 2.6K |
| 2019 | $464.87 | $110.06 | 4.22x | $354.81 | $361.7K | 4.3K | 2.6K |
| 2020 | $513.35 | $123.48 | 4.16x | $389.87 | $320.8K | 3.6K | 2.2K |
| 2021 | $493.57 | $131.61 | 3.75x | $361.96 | $433.8K | 4.1K | 2.5K |
| 2022 | $1.2K | $295.99 | 4.19x | $943.06 | $515.8K | 3.9K | 2.5K |
| 2023 | $1.1K | $263.32 | 4.27x | $860.22 | $1.6M | 7.0K | 5.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78431 | Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan | 531 | $960.8K | $1.8K | 4.10x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 1.1K | $659.8K | $602.02 | 1.93x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.1K | $654.8K | $80.59 | 3.03x |
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 568 | $589.5K | $1.0K | 3.61x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.0K | $391.1K | $129.35 | 6.98x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.4K | $195.3K | $81.43 | 2.34x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.1K | $131.3K | $114.83 | 3.03x |
| 33285 | Insertion of heart rhythm monitor under skin | 65 | $128.4K | $2.0K | 4.94x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 776 | $122.2K | $157.48 | 2.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $122.2K | $113.75 | 3.42x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 8.1K | $92.7K | $11.44 | 6.75x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 159 | $87.9K | $552.96 | 3.90x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.4K | $79.3K | $56.51 | 2.62x |
| 78434 | Nuclear medicine study of heart muscle blood flow by pet | 426 | $58.2K | $136.71 | 4.61x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 251 | $53.9K | $214.70 | 10.56x |
| J2785 | Injection, regadenoson, 0.1 mg | 1.0K | $45.1K | $44.65 | 3.27x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 740 | $43.4K | $58.69 | 3.07x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 394 | $42.3K | $107.25 | 2.56x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 246 | $39.6K | $160.84 | 2.94x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 257 | $37.8K | $147.18 | 4.34x |
This provider submits charges 3.83 times higher than what Medicare actually pays.
A markup ratio of 3.83x means for every $100 Medicare pays, this provider initially charges $383. This is higher than the national average.
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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