This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Advanced Heart Failure and Transplant 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 | $337.53 | $82.84 | 4.07x | $254.69 | $566.9K | 8.5K | 6.6K |
| 2015 | $316.65 | $72.22 | 4.38x | $244.43 | $539.1K | 8.3K | 6.3K |
| 2016 | $306.97 | $70.35 | 4.36x | $236.62 | $429.8K | 7.1K | 5.2K |
| 2017 | $306.11 | $72.22 | 4.24x | $233.89 | $430.0K | 7.2K | 5.2K |
| 2018 | $234.45 | $53.02 | 4.42x | $181.43 | $329.2K | 6.1K | 4.6K |
| 2019 | $201.23 | $52.37 | 3.84x | $148.86 | $288.9K | 5.6K | 4.7K |
| 2020 | $199.69 | $50.45 | 3.96x | $149.24 | $253.7K | 5.0K | 3.9K |
| 2021 | $194.07 | $51.48 | 3.77x | $142.59 | $181.8K | 3.8K | 2.8K |
| 2022 | $168.83 | $47.31 | 3.57x | $121.52 | $156.2K | 3.4K | 2.6K |
| 2023 | $198.80 | $52.19 | 3.81x | $146.61 | $193.5K | 3.5K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 2.9K | $740.3K | $254.48 | 3.30x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 6.7K | $611.9K | $91.44 | 4.88x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.5K | $252.9K | $46.25 | 2.41x |
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the | 3.4K | $198.6K | $57.63 | 5.50x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 1.6K | $167.9K | $106.13 | 5.46x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.1K | $159.6K | $148.03 | 2.80x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.1K | $149.9K | $70.70 | 2.30x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 2.0K | $138.0K | $68.23 | 1.31x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.0K | $106.8K | $54.13 | 2.25x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 2.1K | $98.4K | $46.75 | 7.10x |
| J2785 | Injection, regadenoson, 0.1 mg | 1.4K | $56.8K | $40.24 | 1.30x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 551 | $55.3K | $100.38 | 3.02x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 509 | $50.9K | $99.99 | 2.97x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 4.2K | $42.6K | $10.05 | 8.09x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 548 | $37.6K | $68.69 | 2.78x |
| 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 920 | $34.6K | $37.63 | 4.85x |
| 93308 | Follow-up or limited ultrasound examination of heart | 874 | $32.2K | $36.80 | 4.84x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 356 | $29.0K | $81.59 | 2.10x |
| 93975 | Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow | 179 | $28.2K | $157.80 | 5.79x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 2.2K | $27.4K | $12.68 | 3.70x |
This provider submits charges 3.86 times higher than what Medicare actually pays.
A markup ratio of 3.86x means for every $100 Medicare pays, this provider initially charges $386. 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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