This provider's $10.2M in total Medicare payments ranks in the 99th percentile of Cardiology providers nationally.
Medicare payments to this provider grew 174% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 55% in 2022
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 | $332.87 | $147.01 | 2.26x | $185.86 | $654.0K | 5.3K | 3.6K |
| 2015 | $331.03 | $145.88 | 2.27x | $185.15 | $584.7K | 4.8K | 3.2K |
| 2016 | $284.43 | $121.29 | 2.35x | $163.14 | $598.8K | 5.6K | 4.2K |
| 2017 | $334.14 | $144.63 | 2.31x | $189.51 | $896.4K | 6.3K | 5.1K |
| 2018 | $345.80 | $146.53 | 2.36x | $199.27 | $944.5K | 5.8K | 4.9K |
| 2019 | $390.95 | $157.19 | 2.49x | $233.76 | $1.2M | 6.9K | 6.1K |
| 2020 | $414.10 | $170.04 | 2.44x | $244.06 | $1.0M | 5.7K | 5.1K |
| 2021 | $608.57 | $263.39 | 2.31x | $345.18 | $1.0M | 5.6K | 4.9K |
| 2022 | $574.23 | $230.69 | 2.49x | $343.54 | $1.6M | 6.6K | 5.7K |
| 2023 | $497.70 | $209.01 | 2.38x | $288.69 | $1.8M | 6.4K | 5.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 2.3K | $2.9M | $1.3K | 2.36x |
| 78431 | Multiple nuclear medicine studies of blood flow in heart muscle at rest and with stress, with concurrently acquired ct transmission scan | 1.0K | $2.2M | $2.2K | 2.27x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 3.3K | $1.9M | $567.59 | 1.57x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 5.6K | $965.3K | $173.17 | 3.06x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 10.7K | $909.5K | $84.72 | 2.52x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 687 | $284.4K | $414.01 | 2.32x |
| J2785 | Injection, regadenoson, 0.1 mg | 3.7K | $169.5K | $45.52 | 1.31x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 10.5K | $130.5K | $12.39 | 3.63x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 862 | $112.2K | $130.16 | 2.51x |
| 93017 | Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring | 3.5K | $104.7K | $30.26 | 4.68x |
| 93351 | Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report | 485 | $100.5K | $207.14 | 2.74x |
| 93016 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring and physician supervision | 4.0K | $70.0K | $17.53 | 6.10x |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 651 | $46.2K | $71.01 | 1.38x |
| 93018 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report | 3.5K | $43.0K | $12.36 | 5.10x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 640 | $38.7K | $60.54 | 3.70x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 770 | $37.5K | $48.64 | 2.47x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 579 | $34.7K | $59.86 | 2.02x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 273 | $17.6K | $64.65 | 4.32x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 397 | $15.3K | $38.44 | 1.82x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 124 | $14.2K | $114.18 | 2.31x |
This provider submits charges 2.35 times higher than what Medicare actually pays.
A markup ratio of 2.35x means for every $100 Medicare pays, this provider initially charges $235. 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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