This provider's $5.8M in total Medicare payments ranks in the 98th 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 | $85.67 | $54.28 | 1.58x | $31.39 | $517.5K | 10.6K | 5.7K |
| 2015 | $108.50 | $54.79 | 1.98x | $53.71 | $502.1K | 9.5K | 5.4K |
| 2016 | $86.87 | $54.27 | 1.60x | $32.60 | $512.1K | 9.9K | 5.8K |
| 2017 | $90.71 | $55.07 | 1.65x | $35.64 | $550.9K | 10.4K | 5.8K |
| 2018 | $91.73 | $54.54 | 1.68x | $37.19 | $537.5K | 9.8K | 5.8K |
| 2019 | $104.45 | $61.95 | 1.69x | $42.50 | $641.1K | 11.6K | 7.2K |
| 2020 | $92.49 | $53.94 | 1.71x | $38.55 | $561.7K | 10.2K | 6.2K |
| 2021 | $104.37 | $63.84 | 1.63x | $40.53 | $651.9K | 11.1K | 6.8K |
| 2022 | $98.85 | $59.28 | 1.67x | $39.57 | $604.5K | 11.4K | 7.0K |
| 2023 | $88.35 | $53.97 | 1.64x | $34.38 | $734.3K | 12.7K | 8.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 20.8K | $1.9M | $88.90 | 1.62x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 2.4K | $925.3K | $384.43 | 1.79x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 6.4K | $899.0K | $139.97 | 2.05x |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 2.3K | $340.3K | $147.72 | 1.48x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.5K | $240.2K | $165.31 | 1.53x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.2K | $191.2K | $60.67 | 1.51x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 3.1K | $166.7K | $54.41 | 2.14x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 13.1K | $165.6K | $12.62 | 1.90x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.7K | $151.0K | $55.22 | 1.66x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 1.1K | $74.7K | $64.96 | 2.11x |
| J2785 | Injection, regadenoson, 0.1 mg | 1.5K | $68.9K | $44.79 | 1.35x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 5.0K | $68.7K | $13.84 | 1.32x |
| 80053 | Blood test, comprehensive group of blood chemicals | 5.5K | $60.0K | $10.82 | 1.24x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 2.9K | $54.9K | $18.95 | 1.17x |
| 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 954 | $48.9K | $51.27 | 1.76x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 374 | $46.5K | $124.22 | 1.68x |
| 85610 | Blood test, clotting time | 9.1K | $43.4K | $4.77 | 1.18x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 304 | $36.6K | $120.41 | 1.51x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 383 | $32.3K | $84.31 | 1.66x |
| 84439 | Thyroxine (thyroid chemical) measurement | 2.9K | $29.8K | $10.15 | 1.20x |
This provider submits charges 1.7 times higher than what Medicare actually pays.
A markup ratio of 1.7x means for every $100 Medicare pays, this provider initially charges $170. This is lower than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
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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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