This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Cardiac Surgery 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 | $247.42 | $99.51 | 2.49x | $147.91 | $393.6K | 6.1K | 3.7K |
| 2015 | $247.11 | $98.38 | 2.51x | $148.73 | $355.6K | 5.4K | 3.4K |
| 2016 | $246.81 | $86.61 | 2.85x | $160.20 | $340.6K | 5.3K | 3.2K |
| 2017 | $280.00 | $99.88 | 2.80x | $180.12 | $329.5K | 5.1K | 3.2K |
| 2018 | $254.11 | $89.02 | 2.85x | $165.09 | $325.2K | 5.2K | 3.2K |
| 2019 | $241.39 | $88.64 | 2.72x | $152.75 | $361.8K | 6.0K | 3.1K |
| 2020 | $245.37 | $91.55 | 2.68x | $153.82 | $312.0K | 5.0K | 2.7K |
| 2021 | $227.90 | $90.44 | 2.52x | $137.46 | $361.3K | 5.2K | 3.4K |
| 2022 | $238.67 | $88.24 | 2.70x | $150.43 | $329.5K | 4.6K | 3.1K |
| 2023 | $320.67 | $108.12 | 2.97x | $212.55 | $361.6K | 4.9K | 3.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 4.5K | $636.1K | $139.87 | 4.13x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.3K | $597.8K | $57.96 | 1.71x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 1.1K | $427.4K | $397.58 | 3.78x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.3K | $375.2K | $87.46 | 1.53x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.7K | $214.9K | $58.42 | 1.80x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 804 | $128.9K | $160.38 | 1.82x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 1.9K | $127.7K | $67.65 | 1.70x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 8.8K | $108.9K | $12.32 | 6.09x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 752 | $94.4K | $125.54 | 1.86x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 972 | $94.1K | $96.82 | 2.06x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 1.3K | $72.5K | $54.96 | 3.64x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 346 | $71.2K | $205.74 | 3.69x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 606 | $65.9K | $108.69 | 1.81x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 308 | $49.2K | $159.64 | 1.88x |
| 92928 | Catheter insertion of stents in major coronary artery or branch, accessed through the skin | 90 | $38.0K | $422.18 | 2.06x |
| J2785 | Injection, regadenoson, 0.1 mg | 843 | $37.5K | $44.53 | 1.68x |
| 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 760 | $36.8K | $48.41 | 2.07x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 342 | $34.6K | $101.25 | 1.68x |
| 93356 | Heart muscle strain imaging | 1.2K | $33.3K | $28.02 | 2.86x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 309 | $26.0K | $84.22 | 1.78x |
This provider submits charges 2.73 times higher than what Medicare actually pays.
A markup ratio of 2.73x means for every $100 Medicare pays, this provider initially charges $273. 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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