This provider's $5.7M 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.
Notable: Payments increased 75% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $345.73 | $105.93 | 3.26x | $239.80 | $622.1K | 15.4K | 4.8K |
| 2015 | $302.45 | $93.61 | 3.23x | $208.84 | $511.0K | 8.1K | 4.1K |
| 2016 | $273.88 | $83.28 | 3.29x | $190.60 | $612.2K | 8.6K | 4.8K |
| 2017 | $256.78 | $90.30 | 2.84x | $166.48 | $572.1K | 8.4K | 4.9K |
| 2018 | $270.30 | $85.82 | 3.15x | $184.48 | $656.7K | 10.2K | 4.7K |
| 2019 | $263.65 | $91.04 | 2.90x | $172.61 | $549.1K | 7.8K | 3.7K |
| 2020 | $271.83 | $78.72 | 3.45x | $193.11 | $333.9K | 4.6K | 2.6K |
| 2021 | $238.33 | $85.87 | 2.78x | $152.46 | $582.7K | 8.2K | 3.7K |
| 2022 | $255.17 | $91.07 | 2.80x | $164.10 | $725.3K | 10.4K | 4.1K |
| 2023 | $265.98 | $85.32 | 3.12x | $180.66 | $581.4K | 8.7K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 18.1K | $1.6M | $87.48 | 1.74x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 9.0K | $1.4M | $153.55 | 3.09x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 4.8K | $810.8K | $169.00 | 6.51x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 11.5K | $439.0K | $38.33 | 1.74x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.9K | $240.8K | $123.79 | 1.82x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 4.1K | $198.6K | $48.77 | 1.62x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 14.8K | $194.6K | $13.13 | 5.71x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 3.6K | $155.5K | $43.11 | 1.78x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 671 | $137.4K | $204.81 | 2.69x |
| 93970 | Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers | 761 | $117.5K | $154.42 | 3.24x |
| 93978 | Ultrasound scan of vena cava or groin graft or vessel blood flow | 665 | $93.1K | $139.99 | 3.21x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 5.0K | $79.1K | $15.96 | 2.82x |
| 93922 | Ultrasound study of arteries of both arms and legs | 889 | $53.9K | $60.64 | 4.62x |
| 85610 | Blood test, clotting time | 8.7K | $44.7K | $5.16 | 2.90x |
| 99458 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; each additional 20 minute | 1.0K | $35.7K | $35.03 | 2.26x |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 465 | $24.5K | $52.62 | 1.43x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 401 | $22.5K | $55.99 | 1.79x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 123 | $20.3K | $165.43 | 1.82x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 149 | $19.4K | $130.22 | 1.92x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 324 | $19.4K | $59.79 | 5.85x |
This provider submits charges 3.03 times higher than what Medicare actually pays.
A markup ratio of 3.03x means for every $100 Medicare pays, this provider initially charges $303. 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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