This provider's $8.8M in total Medicare payments ranks in the 99th percentile of Cardiology providers nationally.
Medicare payments to this provider grew 125% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 85% in 2017
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $166.24 | $66.95 | 2.48x | $99.29 | $482.0K | 8.9K | 6.9K |
| 2015 | $193.14 | $73.03 | 2.64x | $120.11 | $470.9K | 8.4K | 6.6K |
| 2016 | $176.32 | $69.50 | 2.54x | $106.82 | $537.2K | 10.0K | 7.4K |
| 2017 | $212.60 | $81.36 | 2.61x | $131.24 | $995.9K | 14.9K | 11.4K |
| 2018 | $230.66 | $88.01 | 2.62x | $142.65 | $1.0M | 14.6K | 11.0K |
| 2019 | $236.69 | $89.82 | 2.64x | $146.87 | $982.6K | 13.8K | 10.5K |
| 2020 | $224.73 | $81.18 | 2.77x | $143.55 | $910.8K | 13.7K | 10.7K |
| 2021 | $233.53 | $89.36 | 2.61x | $144.17 | $1.0M | 13.5K | 10.3K |
| 2022 | $237.79 | $98.31 | 2.42x | $139.48 | $1.2M | 14.1K | 10.1K |
| 2023 | $306.00 | $121.73 | 2.51x | $184.27 | $1.1M | 13.4K | 10.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.7K | $1.2M | $78.85 | 2.41x |
| 78431 | Multiple nuclear medicine studies of blood flow in heart muscle at rest and with stress, with concurrently acquired ct transmission scan | 866 | $1.0M | $1.2K | 3.23x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 2.3K | $812.1K | $360.11 | 2.57x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 11.2K | $622.1K | $55.60 | 1.90x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 5.7K | $586.3K | $102.95 | 2.76x |
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 506 | $538.5K | $1.1K | 3.52x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.0K | $461.7K | $152.48 | 1.97x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 1.4K | $459.4K | $325.35 | 1.45x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 419 | $245.6K | $586.20 | 2.45x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 4.6K | $219.6K | $48.11 | 3.09x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 2.8K | $182.0K | $64.19 | 1.51x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 14.1K | $155.2K | $11.03 | 2.93x |
| 78451 | Nuclear medicine study of vessels of heart using drugs or exercise single study | 579 | $150.5K | $259.85 | 2.60x |
| 71275 | CT scan of blood vessels in chest with contrast | 681 | $139.7K | $205.10 | 3.20x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 3.3K | $131.1K | $39.80 | 2.10x |
| 75574 | CT scan of heart blood vessels and grafts with contrast dye | 545 | $130.3K | $239.03 | 3.00x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.5K | $128.2K | $51.66 | 2.37x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.0K | $117.1K | $111.61 | 2.29x |
| J2785 | Injection, regadenoson, 0.1 mg | 2.6K | $114.8K | $44.58 | 2.51x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.3K | $107.4K | $80.72 | 1.97x |
This provider submits charges 2.52 times higher than what Medicare actually pays.
A markup ratio of 2.52x means for every $100 Medicare pays, this provider initially charges $252. 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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