This provider's $9.2M 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 | $180.36 | $78.16 | 2.31x | $102.20 | $813.8K | 9.0K | 7.3K |
| 2015 | $180.23 | $80.50 | 2.24x | $99.73 | $845.8K | 9.0K | 7.2K |
| 2016 | $197.65 | $92.28 | 2.14x | $105.37 | $1.1M | 10.4K | 8.3K |
| 2017 | $182.29 | $83.12 | 2.19x | $99.17 | $991.8K | 10.0K | 8.1K |
| 2018 | $205.97 | $93.45 | 2.20x | $112.52 | $858.1K | 9.0K | 7.4K |
| 2019 | $262.14 | $92.36 | 2.84x | $169.78 | $889.1K | 9.8K | 7.9K |
| 2020 | $340.85 | $88.92 | 3.83x | $251.93 | $818.0K | 8.8K | 7.3K |
| 2021 | $363.59 | $99.17 | 3.67x | $264.42 | $896.2K | 8.9K | 7.3K |
| 2022 | $324.51 | $86.81 | 3.74x | $237.70 | $1.0M | 10.0K | 8.1K |
| 2023 | $381.80 | $108.48 | 3.52x | $273.32 | $1.0M | 9.1K | 6.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 5.5K | $2.4M | $445.00 | 2.46x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 11.1K | $1.8M | $161.13 | 3.60x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.5K | $1.4M | $99.84 | 2.97x |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 5.5K | $685.2K | $125.61 | 1.93x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 5.6K | $508.4K | $90.84 | 1.78x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.0K | $414.2K | $68.85 | 2.90x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 5.6K | $330.2K | $58.56 | 3.77x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 16.4K | $234.2K | $14.31 | 3.86x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $198.5K | $139.76 | 2.79x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 2.7K | $189.4K | $70.74 | 4.30x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.1K | $154.2K | $139.91 | 2.70x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 808 | $143.9K | $178.11 | 1.62x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.1K | $139.6K | $65.24 | 2.69x |
| 93351 | Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report | 554 | $124.1K | $224.08 | 2.95x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 620 | $77.8K | $125.51 | 3.07x |
| 99284 | Emergency department visit, problem of high severity | 577 | $58.3K | $100.98 | 1.73x |
| J2785 | Injection, regadenoson, 0.1 mg | 1.3K | $57.4K | $44.36 | 2.60x |
| 93299 | Remote evaluations of implantable heart recorder system including transmissions, technician review, support, and distribution of results up to 30 days | 126 | $23.9K | $189.31 | 1.52x |
| 93320 | Doppler ultrasound study of heart blood flow, valves, and chambers | 482 | $23.0K | $47.74 | 3.96x |
| J0280 | Injection, aminophyllin, up to 250 mg | 3.3K | $20.3K | $6.14 | 3.27x |
This provider submits charges 2.86 times higher than what Medicare actually pays.
A markup ratio of 2.86x means for every $100 Medicare pays, this provider initially charges $286. 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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