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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. James Muto
❤️
MDIndividual

James Muto, MD

NPI: 1134222151
Kahului, HI
10 years of data
Cardiology
$6.1M
Total Payments
51.9K
Beneficiaries
73.1K
Services
4.79x
Markup Ratio

Peer Comparison

98th
percentile in specialty
This provider$6.1M
Specialty median$193.1K

📋 Key Findings

1Billed $6.1M over 10 years
24.79x markup ratio (above median)
398th percentile in Cardiology by payments
412 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $6.1M in total Medicare payments ranks in the 98th percentile of Cardiology providers nationally.

Medicare payments to this provider grew 194% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$425.39$92.204.61x$333.19$318.6K3.7K2.6K
2015$397.03$87.874.52x$309.16$385.8K4.3K3.0K
2016$412.27$87.154.73x$325.12$380.8K4.7K3.3K
2017$389.62$92.124.23x$297.50$395.6K4.9K3.3K
2018$438.88$101.154.34x$337.73$413.8K5.2K3.5K
2019$425.85$94.024.53x$331.83$584.1K7.0K5.0K
2020$408.21$94.054.34x$314.16$869.2K9.7K7.5K
2021$386.68$89.194.34x$297.49$931.1K10.6K7.6K
2022$355.43$77.674.58x$277.76$908.6K11.1K7.8K
2023$421.39$91.924.58x$329.47$937.3K11.9K8.1K

Top Procedures (20)

99214Established patient office or other outpatient, visit typically 25 minutes
$1.6M
17.7K services$89.75/svc2.03x markup
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function⚠ 10.4x markup
$1.2M
7.2K services$165.81/svc10.40x markup
93925Ultrasound study of arteries and arterial grafts of both legs⚠ 3.9x markup
$491.2K
2.3K services$215.35/svc3.86x markup
93351Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report⚠ 5.2x markup
$441.9K
2.1K services$208.36/svc5.15x markup
93978Ultrasound scan of vena cava or groin graft or vessel blood flow⚠ 4.0x markup
$437.9K
3.1K services$141.29/svc4.05x markup
93880Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck⚠ 5.3x markup
$382.3K
2.6K services$146.21/svc5.25x markup
99205New patient office or other outpatient visit, typically 60 minutes
$257.1K
1.6K services$159.09/svc1.56x markup
93000Routine EKG using at least 12 leads including interpretation and report⚠ 6.9x markup
$235.1K
18.9K services$12.46/svc6.93x markup
93922Ultrasound study of arteries of both arms and legs⚠ 3.4x markup
$200.8K
2.7K services$74.36/svc3.44x markup
93923Ultrasound study of arteries of both arms and legs⚠ 4.7x markup
$198.7K
2.2K services$90.28/svc4.72x markup
99215Established patient office or other outpatient, visit typically 40 minutes
$180.0K
1.6K services$116.05/svc2.02x markup
99204New patient office or other outpatient visit, typically 45 minutes
$159.9K
1.3K services$120.51/svc1.73x markup
93356Heart muscle strain imaging
$132.2K
3.9K services$33.71/svc2.37x markup
99213Established patient office or other outpatient visit, typically 15 minutes
$57.5K
1.1K services$54.19/svc2.40x markup
93288Evaluation of parameters of single, dual, or multiple lead pacemaker including device connection, recording, and disconnection⚠ 3.3x markup
$33.8K
847 services$39.91/svc3.34x markup
93970Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers⚠ 5.1x markup
$31.9K
197 services$161.80/svc5.08x markup
93289Evaluation of defibrillator including connection, recording and disconnection
$25.0K
486 services$51.38/svc2.59x markup
93248Heart rhythm review and interpretation of continous external ekg over 8-15 days⚠ 8.4x markup
$11.9K
573 services$20.81/svc8.41x markup
99203New patient office or other outpatient visit, typically 30 minutes
$11.2K
142 services$79.20/svc2.04x markup
93320Doppler ultrasound study of heart blood flow, valves, and chambers⚠ 8.0x markup
$8.3K
179 services$46.50/svc8.03x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99214Established patient office or other outpatient, visit typically 25 minutes17.7K$1.6M$89.752.03x
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function7.2K$1.2M$165.8110.40x
93925Ultrasound study of arteries and arterial grafts of both legs2.3K$491.2K$215.353.86x
93351Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report2.1K$441.9K$208.365.15x
93978Ultrasound scan of vena cava or groin graft or vessel blood flow3.1K$437.9K$141.294.05x
93880Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck2.6K$382.3K$146.215.25x
99205New patient office or other outpatient visit, typically 60 minutes1.6K$257.1K$159.091.56x
93000Routine EKG using at least 12 leads including interpretation and report18.9K$235.1K$12.466.93x
93922Ultrasound study of arteries of both arms and legs2.7K$200.8K$74.363.44x
93923Ultrasound study of arteries of both arms and legs2.2K$198.7K$90.284.72x
99215Established patient office or other outpatient, visit typically 40 minutes1.6K$180.0K$116.052.02x
99204New patient office or other outpatient visit, typically 45 minutes1.3K$159.9K$120.511.73x
93356Heart muscle strain imaging3.9K$132.2K$33.712.37x
99213Established patient office or other outpatient visit, typically 15 minutes1.1K$57.5K$54.192.40x
93288Evaluation of parameters of single, dual, or multiple lead pacemaker including device connection, recording, and disconnection847$33.8K$39.913.34x
93970Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers197$31.9K$161.805.08x
93289Evaluation of defibrillator including connection, recording and disconnection486$25.0K$51.382.59x
93248Heart rhythm review and interpretation of continous external ekg over 8-15 days573$11.9K$20.818.41x
99203New patient office or other outpatient visit, typically 30 minutes142$11.2K$79.202.04x
93320Doppler ultrasound study of heart blood flow, valves, and chambers179$8.3K$46.508.03x

Markup Analysis

Charge-to-Payment Ratio

4.79x

This provider submits charges 4.79 times higher than what Medicare actually pays.

What This Means

A markup ratio of 4.79x means for every $100 Medicare pays, this provider initially charges $479. This is higher than the national average.

Location

Kahului, HI

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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