This provider's $7.6M 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 | $523.54 | $118.18 | 4.43x | $405.36 | $748.3K | 8.1K | 5.7K |
| 2015 | $515.24 | $107.06 | 4.81x | $408.18 | $686.8K | 8.4K | 5.6K |
| 2016 | $557.27 | $113.75 | 4.90x | $443.52 | $782.9K | 8.3K | 6.0K |
| 2017 | $579.17 | $122.65 | 4.72x | $456.52 | $745.0K | 7.7K | 5.7K |
| 2018 | $715.63 | $144.85 | 4.94x | $570.78 | $838.1K | 8.5K | 6.3K |
| 2019 | $598.84 | $137.12 | 4.37x | $461.72 | $752.8K | 7.4K | 5.4K |
| 2020 | $667.82 | $151.46 | 4.41x | $516.36 | $792.1K | 7.0K | 5.0K |
| 2021 | $705.00 | $168.68 | 4.18x | $536.32 | $825.7K | 7.0K | 5.3K |
| 2022 | $863.89 | $200.68 | 4.30x | $663.21 | $765.6K | 6.1K | 4.5K |
| 2023 | $638.99 | $139.20 | 4.59x | $499.79 | $692.1K | 5.9K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 1.9K | $2.2M | $1.1K | 4.63x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 6.4K | $856.2K | $134.56 | 6.57x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 1.3K | $794.3K | $620.07 | 7.26x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.4K | $642.8K | $56.63 | 3.36x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.7K | $470.1K | $83.12 | 2.65x |
| A9526 | Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries | 1.6K | $368.0K | $229.44 | 3.15x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 5.9K | $209.3K | $35.64 | 2.95x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.3K | $193.8K | $58.09 | 4.88x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 460 | $173.3K | $376.84 | 3.49x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 380 | $156.6K | $412.20 | 1.94x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 1.0K | $149.9K | $144.29 | 3.19x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 2.6K | $145.5K | $56.65 | 5.30x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 10.3K | $124.2K | $12.11 | 6.61x |
| J2785 | Injection, regadenoson, 0.1 mg | 2.0K | $89.9K | $43.95 | 2.05x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 390 | $82.1K | $210.48 | 6.00x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 668 | $80.4K | $120.30 | 2.83x |
| 78431 | Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan | 47 | $68.7K | $1.5K | 4.45x |
| 75574 | CT scan of heart blood vessels and grafts with contrast dye | 258 | $67.9K | $262.99 | 5.97x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 265 | $50.7K | $191.18 | 2.41x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 459 | $49.1K | $106.93 | 2.34x |
This provider submits charges 4.6 times higher than what Medicare actually pays.
A markup ratio of 4.6x means for every $100 Medicare pays, this provider initially charges $460. 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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