This provider's $5.4M in total Medicare payments ranks in the 98th percentile of Cardiology providers nationally.
Their average markup ratio of 5.48x is significantly above the specialty median of 3.6x.
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 | $216.85 | $83.86 | 2.59x | $132.99 | $472.6K | 6.8K | 3.9K |
| 2015 | $343.54 | $76.25 | 4.51x | $267.29 | $493.2K | 7.2K | 3.9K |
| 2016 | $386.93 | $78.69 | 4.92x | $308.24 | $542.8K | 7.9K | 4.1K |
| 2017 | $357.66 | $77.19 | 4.63x | $280.47 | $541.6K | 8.2K | 4.2K |
| 2018 | $425.64 | $67.69 | 6.29x | $357.95 | $568.9K | 9.1K | 4.7K |
| 2019 | $352.53 | $69.69 | 5.06x | $282.84 | $614.9K | 9.8K | 4.8K |
| 2020 | $473.96 | $67.69 | 7.00x | $406.27 | $498.1K | 7.8K | 4.3K |
| 2021 | $500.62 | $64.41 | 7.77x | $436.21 | $595.8K | 8.3K | 4.4K |
| 2022 | $529.10 | $71.78 | 7.37x | $457.32 | $538.0K | 7.9K | 4.2K |
| 2023 | $473.86 | $61.53 | 7.70x | $412.33 | $500.9K | 7.6K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 22.9K | $2.3M | $98.26 | 4.43x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 7.2K | $1.4M | $197.55 | 6.94x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.6K | $500.2K | $66.19 | 4.22x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 29.2K | $416.2K | $14.26 | 7.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.4K | $346.7K | $145.41 | 4.72x |
| 93288 | Evaluation of parameters of single, dual, or multiple lead pacemaker including device connection, recording, and disconnection | 1.7K | $64.7K | $37.45 | 9.41x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 583 | $54.0K | $92.59 | 4.32x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 211 | $38.0K | $180.05 | 4.51x |
| 93308 | Follow-up or limited ultrasound examination of heart | 254 | $25.4K | $100.10 | 7.05x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 345 | $22.8K | $66.19 | 3.35x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 145 | $20.3K | $139.88 | 4.59x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 203 | $18.3K | $90.34 | 3.48x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 143 | $18.0K | $126.21 | 3.53x |
| 93289 | Evaluation of defibrillator including connection, recording and disconnection | 316 | $17.7K | $56.13 | 9.25x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 406 | $15.1K | $37.19 | 3.75x |
| 93268 | Heart rhythm symptom-related tracing and interpretation of 24-hour EKG monitoring up to 30 days | 73 | $14.1K | $192.50 | 6.40x |
| 99406 | Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes | 849 | $14.0K | $16.54 | 5.01x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 174 | $12.5K | $71.89 | 7.04x |
| 36415 | Insertion of needle into vein for collection of blood sample | 3.6K | $12.1K | $3.35 | 5.54x |
| 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 190 | $10.8K | $56.60 | 7.73x |
This provider submits charges 5.48 times higher than what Medicare actually pays.
A markup ratio of 5.48x means for every $100 Medicare pays, this provider initially charges $548. 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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