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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. Durga Madala
❤️
MDIndividual

Durga Madala, M.D.

NPI: 1184650772
San Jose, CA
10 years of data
Cardiology
$5.4M
Total Payments
46.0K
Beneficiaries
68.4K
Services
2.4x
Markup Ratio

Peer Comparison

98th
percentile in specialty
This provider$5.4M
Specialty median$193.1K

📋 Key Findings

1Billed $5.4M over 10 years
22.4x markup ratio (above median)
398th percentile in Cardiology by payments
47 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $5.4M in total Medicare payments ranks in the 98th percentile of Cardiology providers nationally.

Medicare payments to this provider grew 87% 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$274.42$104.912.62x$169.51$402.8K5.7K3.0K
2015$235.48$95.012.48x$140.47$390.3K5.6K3.2K
2016$215.32$85.352.52x$129.97$324.9K5.3K3.2K
2017$204.25$74.762.73x$129.49$445.5K6.5K4.1K
2018$202.00$72.412.79x$129.59$465.9K7.0K4.6K
2019$211.94$82.772.56x$129.17$536.3K7.3K4.9K
2020$218.72$86.792.52x$131.93$591.4K7.0K5.1K
2021$233.15$86.962.68x$146.19$721.2K8.0K5.8K
2022$213.68$81.402.63x$132.28$738.8K8.2K6.0K
2023$269.06$93.752.87x$175.31$755.2K7.7K6.2K

Top Procedures (20)

99214Established patient office or other outpatient, visit typically 25 minutes
$1.3M
13.1K services$99.54/svc2.06x markup
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function
$1.3M
6.4K services$201.39/svc2.65x markup
99213Established patient office or other outpatient visit, typically 15 minutes
$602.9K
8.5K services$70.72/svc1.98x markup
78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies
$572.5K
1.2K services$488.44/svc2.04x markup
93351Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report
$403.2K
1.7K services$234.31/svc2.31x markup
99204New patient office or other outpatient visit, typically 45 minutes
$262.5K
1.8K services$143.84/svc2.19x markup
93000Routine EKG using at least 12 leads including interpretation and report⚠ 3.0x markup
$255.5K
17.8K services$14.36/svc3.04x markup
93880Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck
$193.2K
959 services$201.45/svc2.16x markup
A9500Technetium tc-99m sestamibi, diagnostic, per study dose
$103.6K
1.2K services$88.77/svc2.81x markup
93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report
$88.7K
1.4K services$61.20/svc2.20x markup
J2785Injection, regadenoson, 0.1 mg
$42.1K
939 services$44.79/svc2.23x markup
93015Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report⚠ 3.2x markup
$36.4K
578 services$62.94/svc3.23x markup
99233Subsequent hospital inpatient care, typically 35 minutes per day
$24.1K
252 services$95.61/svc2.08x markup
85610Blood test, clotting time⚠ 5.0x markup
$23.8K
4.7K services$5.04/svc4.96x markup
99291Critical care delivery critically ill or injured patient, first 30-74 minutes
$23.2K
121 services$191.90/svc2.74x markup
93224Heart rhythm tracing, analysis, and interpretation of 48-hour EKG⚠ 4.1x markup
$13.4K
182 services$73.64/svc4.07x markup
93296Remote evaluations of defibrillator transmissions, technician review, support and distribution of results up to 90 days⚠ 3.2x markup
$12.9K
513 services$25.16/svc3.18x markup
93017Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring⚠ 4.2x markup
$11.5K
395 services$29.10/svc4.23x markup
93294Remote evaluations of single, dual, or multiple lead pacemaker with physician analysis, review, and report up to 90 days
$10.7K
413 services$25.94/svc2.81x markup
93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report⚠ 8.5x markup
$9.9K
1.4K services$7.20/svc8.47x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99214Established patient office or other outpatient, visit typically 25 minutes13.1K$1.3M$99.542.06x
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function6.4K$1.3M$201.392.65x
99213Established patient office or other outpatient visit, typically 15 minutes8.5K$602.9K$70.721.98x
78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies1.2K$572.5K$488.442.04x
93351Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report1.7K$403.2K$234.312.31x
99204New patient office or other outpatient visit, typically 45 minutes1.8K$262.5K$143.842.19x
93000Routine EKG using at least 12 leads including interpretation and report17.8K$255.5K$14.363.04x
93880Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck959$193.2K$201.452.16x
A9500Technetium tc-99m sestamibi, diagnostic, per study dose1.2K$103.6K$88.772.81x
93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report1.4K$88.7K$61.202.20x
J2785Injection, regadenoson, 0.1 mg939$42.1K$44.792.23x
93015Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report578$36.4K$62.943.23x
99233Subsequent hospital inpatient care, typically 35 minutes per day252$24.1K$95.612.08x
85610Blood test, clotting time4.7K$23.8K$5.044.96x
99291Critical care delivery critically ill or injured patient, first 30-74 minutes121$23.2K$191.902.74x
93224Heart rhythm tracing, analysis, and interpretation of 48-hour EKG182$13.4K$73.644.07x
93296Remote evaluations of defibrillator transmissions, technician review, support and distribution of results up to 90 days513$12.9K$25.163.18x
93017Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring395$11.5K$29.104.23x
93294Remote evaluations of single, dual, or multiple lead pacemaker with physician analysis, review, and report up to 90 days413$10.7K$25.942.81x
93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report1.4K$9.9K$7.208.47x

Markup Analysis

Charge-to-Payment Ratio

2.4x

This provider submits charges 2.4 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.4x means for every $100 Medicare pays, this provider initially charges $240. This is higher than the national average.

Location

San Jose, CA

Provider Verification

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

Similar Providers

Other Cardiology providers in CA for peer comparison.

Durga Madala (you)
$5.4M
Leo Polosajian, M.D.
$52.5M
Athar Ansari, M.D.
$38.2M
Hanumandla Reddy, M.D
$38.1M
Mehran Khorsandi, M.D.,
$36.4M
Shashi Sharma, D.M.
$35.4M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Leo Polosajian, M.D.Reseda, CA$52.5M✓ Clear
Athar Ansari, M.D.El Centro, CA$38.2M✓ Clear
Hanumandla Reddy, M.DHanford, CA$38.1M✓ Clear
Mehran Khorsandi, M.D.,Los Angeles, CA$36.4M✓ Clear
Shashi Sharma, D.M.Visalia, CA$35.4M✓ Clear

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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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