This provider's $10.7M in total Medicare payments ranks in the 99th percentile of 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 | $544.85 | $121.31 | 4.49x | $423.54 | $969.9K | 10.1K | 6.5K |
| 2015 | $617.55 | $127.42 | 4.85x | $490.13 | $943.7K | 9.6K | 6.5K |
| 2016 | $558.81 | $116.00 | 4.82x | $442.81 | $954.8K | 9.1K | 6.6K |
| 2017 | $591.85 | $124.30 | 4.76x | $467.55 | $1.0M | 9.3K | 6.9K |
| 2018 | $634.47 | $139.01 | 4.56x | $495.46 | $1.1M | 10.4K | 7.3K |
| 2019 | $639.93 | $141.91 | 4.51x | $498.02 | $1.3M | 10.5K | 7.7K |
| 2020 | $698.57 | $164.51 | 4.25x | $534.06 | $1.3M | 10.2K | 7.2K |
| 2021 | $606.68 | $145.45 | 4.17x | $461.23 | $1.2M | 10.4K | 7.6K |
| 2022 | $753.45 | $175.43 | 4.29x | $578.02 | $1.1M | 9.7K | 6.3K |
| 2023 | $526.74 | $110.76 | 4.76x | $415.98 | $787.0K | 8.9K | 5.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 3.0K | $3.4M | $1.2K | 4.60x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 2.1K | $1.3M | $610.55 | 7.37x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.1K | $998.8K | $82.45 | 2.67x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 5.4K | $743.9K | $137.70 | 6.59x |
| A9526 | Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries | 2.5K | $569.6K | $226.76 | 3.15x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 808 | $300.7K | $372.21 | 3.53x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 7.2K | $256.9K | $35.87 | 2.93x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 3.9K | $220.6K | $56.78 | 5.28x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 522 | $213.2K | $408.44 | 1.91x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.5K | $160.2K | $63.67 | 2.98x |
| 93297 | Remote evaluations of implantable heart monitoring system with physician analysis, review, and report up to 30 days | 7.6K | $159.0K | $20.85 | 3.37x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $145.7K | $122.19 | 2.78x |
| J2785 | Injection, regadenoson, 0.1 mg | 3.2K | $142.0K | $44.10 | 2.04x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 933 | $137.6K | $147.47 | 3.12x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 9.6K | $116.5K | $12.11 | 6.61x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.3K | $107.7K | $83.16 | 4.70x |
| 75574 | CT scan of heart blood vessels and grafts with contrast dye | 363 | $93.6K | $257.87 | 6.09x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 177 | $87.8K | $495.79 | 3.28x |
| 78431 | Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan | 59 | $86.1K | $1.5K | 4.45x |
| 33249 | Insertion or replacement of single or dual chamber pacing defibrillator leads | 108 | $80.6K | $746.24 | 5.11x |
This provider submits charges 4.54 times higher than what Medicare actually pays.
A markup ratio of 4.54x means for every $100 Medicare pays, this provider initially charges $454. 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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