This provider's $7.4M in total Medicare payments ranks in the 99th percentile of Interventional Cardiology providers nationally.
Their average markup ratio of 5.86x is significantly above the specialty median of 4.0x.
Medicare payments to this provider grew 1446% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 202% in 2016
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $670.98 | $128.03 | 5.24x | $542.95 | $105.0K | 933 | 881 |
| 2016 | $674.46 | $124.49 | 5.42x | $549.97 | $316.8K | 3.1K | 2.6K |
| 2017 | $831.17 | $136.87 | 6.07x | $694.30 | $345.9K | 3.5K | 3.1K |
| 2018 | $816.28 | $132.55 | 6.16x | $683.73 | $657.2K | 6.2K | 5.3K |
| 2019 | $986.37 | $129.07 | 7.64x | $857.30 | $881.7K | 7.7K | 6.5K |
| 2020 | $954.10 | $127.60 | 7.48x | $826.50 | $1.1M | 7.6K | 6.3K |
| 2021 | $1.2K | $197.65 | 6.11x | $1.0K | $1.1M | 8.2K | 6.6K |
| 2022 | $1.3K | $204.51 | 6.34x | $1.1K | $1.3M | 11.0K | 9.0K |
| 2023 | $1.6K | $202.80 | 8.08x | $1.4K | $1.6M | 14.4K | 11.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78431 | Multiple nuclear medicine studies of blood flow in heart muscle at rest and with stress, with concurrently acquired ct transmission scan | 1.5K | $2.4M | $1.6K | 4.24x |
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 769 | $754.1K | $980.62 | 4.79x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 6.9K | $736.8K | $106.75 | 6.85x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.5K | $504.3K | $77.76 | 2.20x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 2.3K | $386.5K | $170.70 | 17.19x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.8K | $199.1K | $111.68 | 2.09x |
| 92928 | Catheter insertion of stents in major coronary artery or branch, accessed through the skin | 494 | $195.5K | $395.82 | 4.70x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 922 | $164.3K | $178.17 | 8.52x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 798 | $162.3K | $203.37 | 5.54x |
| 33285 | Insertion of heart rhythm monitor under skin | 152 | $158.3K | $1.0K | 16.55x |
| 33361 | Replacement of aortic valve with prosthetic valve, accessed through the skin | 242 | $141.7K | $585.61 | 8.69x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 2.6K | $125.5K | $49.15 | 8.92x |
| 33418 | Replacement of aortic valve with prosthetic valve accessed through the skin | 112 | $117.9K | $1.1K | 6.50x |
| 37225 | Removal of plaque in arteries of leg | 20 | $110.2K | $5.5K | 6.20x |
| J2785 | Injection, regadenoson, 0.1 mg | 2.4K | $108.6K | $45.03 | 2.20x |
| 78434 | Nuclear medicine study of heart muscle blood flow by pet | 825 | $104.0K | $126.01 | 4.52x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 8.7K | $90.2K | $10.41 | 7.51x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 674 | $65.8K | $97.67 | 2.51x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $62.8K | $47.19 | 2.30x |
| 93460 | Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart | 221 | $55.1K | $249.41 | 6.60x |
This provider submits charges 5.86 times higher than what Medicare actually pays.
A markup ratio of 5.86x means for every $100 Medicare pays, this provider initially charges $586. 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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