This provider's $8.1M 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 | $370.55 | $124.20 | 2.98x | $246.35 | $901.9K | 9.9K | 7.5K |
| 2015 | $298.70 | $102.73 | 2.91x | $195.97 | $845.7K | 9.3K | 7.2K |
| 2016 | $322.61 | $104.42 | 3.09x | $218.19 | $798.7K | 9.0K | 6.8K |
| 2017 | $295.64 | $99.69 | 2.97x | $195.95 | $810.7K | 9.2K | 7.1K |
| 2018 | $254.46 | $84.59 | 3.01x | $169.87 | $794.3K | 9.7K | 7.6K |
| 2019 | $284.54 | $99.06 | 2.87x | $185.48 | $886.0K | 10.2K | 8.0K |
| 2020 | $266.77 | $93.88 | 2.84x | $172.89 | $751.7K | 9.0K | 7.2K |
| 2021 | $268.47 | $94.61 | 2.84x | $173.86 | $772.9K | 8.6K | 6.9K |
| 2022 | $262.84 | $90.89 | 2.89x | $171.95 | $793.6K | 8.9K | 7.1K |
| 2023 | $272.08 | $92.55 | 2.94x | $179.53 | $731.0K | 8.4K | 6.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 6.8K | $2.0M | $301.56 | 2.06x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 10.6K | $1.2M | $115.68 | 3.00x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.3K | $1.2M | $80.62 | 2.51x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 12.2K | $691.1K | $56.58 | 2.46x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 5.5K | $500.6K | $90.52 | 3.76x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.2K | $487.7K | $152.16 | 2.55x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 2.6K | $355.0K | $136.58 | 3.30x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 5.6K | $273.5K | $48.86 | 4.41x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.0K | $222.7K | $56.22 | 2.29x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 813 | $165.0K | $202.92 | 3.41x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $148.4K | $115.65 | 2.65x |
| 92928 | Catheter insertion of stents in major coronary artery or branch, accessed through the skin | 291 | $140.7K | $483.40 | 3.42x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 2.4K | $139.0K | $58.48 | 3.27x |
| 96374 | Injection of drug or substance into a vein for therapy, diagnosis, or prevention | 3.7K | $118.7K | $31.72 | 3.32x |
| 99220 | Hospital observation care typically 70 minutes per day | 640 | $87.2K | $136.17 | 2.22x |
| 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 9.2K | $60.4K | $6.59 | 3.21x |
| 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 999 | $46.3K | $46.34 | 2.71x |
| 93452 | Insertion of catheter into left heart for diagnosis | 323 | $34.0K | $105.32 | 5.35x |
| 93016 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring and physician supervision | 1.4K | $23.2K | $17.13 | 3.01x |
| 93459 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 100 | $22.8K | $228.12 | 3.41x |
This provider submits charges 2.73 times higher than what Medicare actually pays.
A markup ratio of 2.73x means for every $100 Medicare pays, this provider initially charges $273. 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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