This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Advanced Heart Failure and Transplant Cardiology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
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 | $262.72 | $71.38 | 3.68x | $191.34 | $396.4K | 6.5K | 3.6K |
| 2015 | $247.14 | $72.62 | 3.40x | $174.52 | $368.2K | 5.9K | 3.4K |
| 2016 | $318.98 | $90.43 | 3.53x | $228.55 | $393.8K | 6.2K | 3.7K |
| 2017 | $278.16 | $80.06 | 3.47x | $198.10 | $397.0K | 6.5K | 3.6K |
| 2018 | $316.22 | $78.12 | 4.05x | $238.10 | $354.1K | 6.4K | 3.9K |
| 2019 | $423.78 | $89.40 | 4.74x | $334.38 | $349.0K | 6.4K | 4.0K |
| 2020 | $382.49 | $83.76 | 4.57x | $298.73 | $296.8K | 5.2K | 3.3K |
| 2021 | $356.98 | $83.00 | 4.30x | $273.98 | $333.1K | 5.2K | 3.3K |
| 2022 | $352.71 | $79.55 | 4.43x | $273.16 | $309.1K | 5.3K | 3.4K |
| 2023 | $379.61 | $84.53 | 4.49x | $295.08 | $271.5K | 4.7K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 15.3K | $1.2M | $78.96 | 3.69x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.4K | $355.5K | $104.72 | 3.98x |
| 93351 | Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report | 1.6K | $311.7K | $189.51 | 3.70x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 3.1K | $253.5K | $81.47 | 3.50x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 15.9K | $185.7K | $11.68 | 4.86x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.5K | $160.0K | $106.12 | 3.55x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 962 | $147.4K | $153.23 | 3.62x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 892 | $132.1K | $148.14 | 3.71x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.9K | $107.5K | $56.95 | 3.86x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 606 | $86.2K | $142.32 | 4.91x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 423 | $81.6K | $192.90 | 3.46x |
| 93320 | Doppler ultrasound study of heart blood flow, valves, and chambers | 2.1K | $70.8K | $33.16 | 4.41x |
| 93312 | Insertion of probe in esophagus for heart ultrasound examination including interpretation and report | 684 | $60.2K | $88.04 | 3.26x |
| 92960 | External shock to heart to regulate heart beat | 425 | $38.2K | $89.87 | 6.16x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 205 | $37.5K | $183.02 | 4.24x |
| G0166 | External counterpulsation, per treatment session | 288 | $29.7K | $103.08 | 8.00x |
| 93325 | Doppler ultrasound study of color-directed heart blood flow, rate, and valve function | 1.8K | $29.6K | $16.31 | 7.36x |
| 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 4.3K | $27.8K | $6.51 | 4.51x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 374 | $20.7K | $55.45 | 3.63x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 128 | $17.6K | $137.88 | 3.51x |
This provider submits charges 3.91 times higher than what Medicare actually pays.
A markup ratio of 3.91x means for every $100 Medicare pays, this provider initially charges $391. 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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