This provider's $21.2M 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 | $297.24 | $124.43 | 2.39x | $172.81 | $1.9M | 10.8K | 9.0K |
| 2015 | $286.10 | $123.02 | 2.33x | $163.08 | $2.0M | 11.2K | 9.3K |
| 2016 | $289.67 | $123.07 | 2.35x | $166.60 | $2.1M | 10.9K | 9.3K |
| 2017 | $270.69 | $119.34 | 2.27x | $151.35 | $1.7M | 9.4K | 7.9K |
| 2018 | $296.35 | $128.86 | 2.30x | $167.49 | $1.9M | 9.8K | 7.9K |
| 2019 | $326.36 | $131.84 | 2.48x | $194.52 | $2.0M | 10.0K | 8.3K |
| 2020 | $341.62 | $133.26 | 2.56x | $208.36 | $2.1M | 9.0K | 7.7K |
| 2021 | $295.00 | $125.43 | 2.35x | $169.57 | $2.2M | 9.3K | 8.1K |
| 2022 | $371.49 | $162.75 | 2.28x | $208.74 | $2.7M | 10.0K | 8.5K |
| 2023 | $320.46 | $147.07 | 2.18x | $173.39 | $2.4M | 9.6K | 8.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 7.4K | $7.5M | $1.0K | 2.17x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 9.0K | $5.3M | $587.23 | 1.28x |
| 78431 | Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan | 1.6K | $2.7M | $1.6K | 2.13x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 5.1K | $1.6M | $320.08 | 2.46x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.1K | $606.0K | $75.11 | 1.70x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 5.2K | $547.8K | $105.83 | 3.75x |
| J2785 | Injection, regadenoson, 0.1 mg | 11.3K | $498.2K | $44.02 | 1.52x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 4.8K | $485.1K | $101.85 | 1.30x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.0K | $347.9K | $49.42 | 1.78x |
| 78434 | Nuclear medicine study of heart muscle blood flow by pet | 1.6K | $209.2K | $127.49 | 2.12x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 659 | $157.1K | $238.37 | 3.15x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 14.3K | $154.3K | $10.76 | 4.95x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.8K | $154.1K | $55.37 | 1.63x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 2.9K | $139.5K | $48.32 | 5.51x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 926 | $105.7K | $114.17 | 1.70x |
| 93312 | Insertion of probe in esophagus for heart ultrasound examination including interpretation and report | 1.2K | $104.7K | $84.46 | 2.82x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 954 | $100.2K | $105.05 | 1.72x |
| 93459 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 232 | $62.2K | $267.91 | 3.13x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 461 | $48.1K | $104.40 | 1.72x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 569 | $45.4K | $79.80 | 1.55x |
This provider submits charges 2.01 times higher than what Medicare actually pays.
A markup ratio of 2.01x means for every $100 Medicare pays, this provider initially charges $201. 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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