This provider's $3.7M in total Medicare payments ranks in the 97th 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 | $220.01 | $59.32 | 3.71x | $160.69 | $452.6K | 9.0K | 5.7K |
| 2015 | $246.21 | $63.81 | 3.86x | $182.40 | $525.2K | 11.0K | 6.3K |
| 2016 | $247.33 | $63.99 | 3.87x | $183.34 | $424.8K | 8.6K | 5.0K |
| 2017 | $243.79 | $65.01 | 3.75x | $178.78 | $388.1K | 7.8K | 4.5K |
| 2018 | $220.45 | $59.25 | 3.72x | $161.20 | $347.9K | 7.6K | 4.4K |
| 2019 | $236.06 | $60.63 | 3.89x | $175.43 | $362.9K | 8.9K | 5.7K |
| 2020 | $209.06 | $56.47 | 3.70x | $152.59 | $332.8K | 7.4K | 4.6K |
| 2021 | $215.32 | $58.64 | 3.67x | $156.68 | $287.3K | 5.9K | 3.8K |
| 2022 | $220.52 | $56.53 | 3.90x | $163.99 | $257.8K | 6.3K | 4.3K |
| 2023 | $235.78 | $59.40 | 3.97x | $176.38 | $301.3K | 6.1K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.5K | $581.6K | $77.59 | 2.47x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 4.5K | $499.3K | $111.34 | 4.96x |
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the | 9.0K | $493.8K | $54.84 | 5.78x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 1.2K | $427.4K | $342.75 | 3.26x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.9K | $292.2K | $49.95 | 2.43x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.6K | $194.7K | $54.45 | 2.24x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.2K | $180.1K | $150.58 | 2.77x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $124.0K | $113.31 | 3.11x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 1.2K | $85.4K | $68.38 | 1.29x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 1.5K | $69.4K | $47.15 | 7.05x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 553 | $56.3K | $101.76 | 2.97x |
| 93296 | Remote evaluations of single, dual, or multiple lead pacemaker or cardioverter-defibrillator transmissions, technician review, support, and distribution of results up to 90 days | 3.4K | $55.2K | $16.01 | 6.40x |
| G0250 | Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent | 8.8K | $54.7K | $6.24 | 4.16x |
| 93294 | Remote evaluations of single, dual, or multiple lead pacemaker with physician analysis, review, and report up to 90 days | 2.6K | $54.7K | $21.32 | 4.85x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 5.2K | $53.1K | $10.26 | 7.96x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 3.3K | $42.5K | $13.03 | 3.63x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 1.4K | $40.5K | $29.37 | 3.07x |
| J2785 | Injection, regadenoson, 0.1 mg | 927 | $37.4K | $40.37 | 1.31x |
| 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 6.0K | $36.9K | $6.13 | 5.55x |
| 93295 | Remote evaluations of single, dual, or multiple lead cardioverter-defibrillator with physician analysis, review, and report up to 90 days | 901 | $34.7K | $38.50 | 4.86x |
This provider submits charges 3.83 times higher than what Medicare actually pays.
A markup ratio of 3.83x means for every $100 Medicare pays, this provider initially charges $383. 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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