This provider's $8.0M 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 | $175.84 | $82.09 | 2.14x | $93.75 | $750.1K | 8.6K | 7.3K |
| 2015 | $187.19 | $84.79 | 2.21x | $102.40 | $731.8K | 8.3K | 7.0K |
| 2016 | $181.47 | $82.29 | 2.21x | $99.18 | $673.0K | 7.2K | 6.2K |
| 2017 | $178.49 | $83.78 | 2.13x | $94.71 | $843.2K | 9.4K | 7.7K |
| 2018 | $192.99 | $84.56 | 2.28x | $108.43 | $735.6K | 7.9K | 6.5K |
| 2019 | $248.38 | $86.87 | 2.86x | $161.51 | $820.8K | 8.6K | 7.4K |
| 2020 | $334.52 | $89.00 | 3.76x | $245.52 | $775.4K | 7.6K | 6.8K |
| 2021 | $335.76 | $91.42 | 3.67x | $244.34 | $786.1K | 7.8K | 6.7K |
| 2022 | $285.02 | $75.86 | 3.76x | $209.16 | $902.4K | 8.8K | 7.6K |
| 2023 | $322.82 | $93.57 | 3.45x | $229.25 | $995.0K | 11.1K | 8.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 5.5K | $2.5M | $446.22 | 2.63x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 9.1K | $1.5M | $161.22 | 3.57x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 10.5K | $1.0M | $97.64 | 2.92x |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 5.5K | $707.3K | $127.89 | 2.04x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.6K | $418.3K | $91.01 | 1.68x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 5.5K | $323.9K | $58.75 | 3.80x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $207.3K | $140.25 | 2.68x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 11.6K | $165.2K | $14.30 | 3.87x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 903 | $161.9K | $179.26 | 1.66x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 1.9K | $131.3K | $70.69 | 4.30x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.7K | $118.3K | $67.79 | 3.26x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 882 | $111.1K | $125.94 | 3.59x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.5K | $110.9K | $72.41 | 3.32x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.5K | $99.6K | $40.47 | 2.68x |
| 93299 | Remote evaluations of implantable heart recorder system including transmissions, technician review, support, and distribution of results up to 30 days | 505 | $98.7K | $195.47 | 1.53x |
| 93351 | Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report | 422 | $96.1K | $227.83 | 2.89x |
| 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 9.7K | $69.6K | $7.19 | 4.34x |
| J2785 | Injection, regadenoson, 0.1 mg | 1.4K | $62.8K | $44.64 | 2.62x |
| 99284 | Emergency department visit, problem of high severity | 576 | $59.6K | $103.55 | 1.76x |
| J0280 | Injection, aminophyllin, up to 250 mg | 3.4K | $21.0K | $6.20 | 3.42x |
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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