This provider's $4.4M in total Medicare payments ranks in the 98th 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 | $190.97 | $53.82 | 3.55x | $137.15 | $463.3K | 9.1K | 6.3K |
| 2015 | $162.73 | $49.37 | 3.30x | $113.36 | $447.5K | 8.0K | 5.5K |
| 2016 | $210.91 | $62.92 | 3.35x | $147.99 | $480.2K | 6.3K | 3.9K |
| 2017 | $226.02 | $66.80 | 3.38x | $159.22 | $463.5K | 6.1K | 3.9K |
| 2018 | $228.19 | $68.56 | 3.33x | $159.63 | $494.7K | 6.5K | 4.1K |
| 2019 | $229.84 | $69.68 | 3.30x | $160.16 | $507.6K | 6.6K | 4.2K |
| 2020 | $220.58 | $66.96 | 3.29x | $153.62 | $434.4K | 5.6K | 3.6K |
| 2021 | $226.64 | $71.67 | 3.16x | $154.97 | $418.9K | 4.8K | 3.1K |
| 2022 | $261.31 | $77.89 | 3.35x | $183.42 | $356.9K | 4.1K | 2.7K |
| 2023 | $287.25 | $87.73 | 3.27x | $199.52 | $329.2K | 3.9K | 2.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 15.6K | $1.8M | $112.40 | 3.10x |
| 93351 | Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report | 3.7K | $731.0K | $197.74 | 3.06x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.0K | $480.1K | $158.20 | 3.03x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.4K | $272.4K | $79.57 | 3.27x |
| 93320 | Doppler ultrasound study of heart blood flow, valves, and chambers | 3.1K | $125.5K | $40.73 | 3.31x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 684 | $103.2K | $150.85 | 3.30x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 8.4K | $102.4K | $12.25 | 3.92x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 599 | $89.2K | $148.91 | 2.91x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 1.2K | $74.9K | $62.62 | 3.94x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 374 | $69.9K | $187.00 | 4.24x |
| 93325 | Doppler ultrasound study of color-directed heart blood flow, rate, and valve function | 3.1K | $61.6K | $19.99 | 3.55x |
| 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 1.6K | $57.4K | $36.63 | 3.67x |
| 95800 | Study of sleep patterns | 431 | $57.1K | $132.47 | 3.43x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 598 | $55.5K | $92.85 | 2.82x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 705 | $38.9K | $55.18 | 3.19x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 660 | $30.3K | $45.90 | 3.18x |
| 94729 | Measurement of lung diffusing capacity | 654 | $28.4K | $43.49 | 2.99x |
| 92960 | External shock to heart to regulate heart beat | 186 | $27.0K | $145.42 | 3.75x |
| 94727 | Determination of lung volumes using gas dilution or washout | 659 | $22.3K | $33.77 | 2.99x |
| 95250 | Ambulatory continuous glucose (sugar) monitoring for a minimum of 72 hours | 151 | $18.4K | $121.82 | 3.05x |
This provider submits charges 3.18 times higher than what Medicare actually pays.
A markup ratio of 3.18x means for every $100 Medicare pays, this provider initially charges $318. 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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