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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Paul Teirstein
❤️
MDIndividual

Paul Teirstein, M.D.

NPI: 1548210768
La Jolla, CA
10 years of data
Interventional Cardiology
$3.7M
Total Payments
20.2K
Beneficiaries
22.5K
Services
4.14x
Markup Ratio

Peer Comparison

97th
percentile in specialty
This provider$3.7M
Specialty median$201.5K

📋 Key Findings

1Billed $3.7M over 10 years
24.14x markup ratio (above median)
397th percentile in Interventional Cardiology by payments
419 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $3.7M in total Medicare payments ranks in the 97th percentile of Interventional Cardiology providers nationally.

This provider's billing patterns fall within normal ranges for their specialty.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$790.23$224.863.51x$565.37$430.8K2.4K2.0K
2015$692.19$197.893.50x$494.30$406.5K2.2K1.9K
2016$713.85$200.133.57x$513.72$422.4K2.3K2.0K
2017$642.46$167.553.83x$474.91$376.9K2.1K1.9K
2018$673.81$180.463.73x$493.35$368.7K2.2K2.0K
2019$682.62$181.473.76x$501.15$465.9K2.9K2.6K
2020$900.27$188.554.77x$711.72$272.1K1.8K1.6K
2021$918.22$191.314.80x$726.91$360.3K2.4K2.2K
2022$891.22$182.494.88x$708.73$310.1K2.1K1.9K
2023$824.67$177.424.65x$647.25$311.8K2.2K2.0K

Top Procedures (20)

92928Catheter insertion of stents in major coronary artery or branch, accessed through the skin⚠ 4.3x markup
$763.2K
2.0K services$391.00/svc4.35x markup
33361Replacement of aortic valve with prosthetic valve, accessed through the skin⚠ 3.7x markup
$494.2K
760 services$650.28/svc3.71x markup
93458Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart⚠ 5.5x markup
$283.5K
1.8K services$161.24/svc5.55x markup
92943Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin⚠ 3.6x markup
$270.8K
518 services$522.75/svc3.63x markup
99223Initial hospital inpatient care, typically 70 minutes per day⚠ 3.1x markup
$217.9K
1.3K services$161.67/svc3.12x markup
99236Hospital observation or inpatient care high severity, 55 minutes per day⚠ 3.3x markup
$189.5K
1.1K services$175.83/svc3.28x markup
99204New patient office or other outpatient visit, typically 45 minutes⚠ 3.7x markup
$135.2K
1.1K services$117.73/svc3.67x markup
92920Balloon dilation of narrowed or blocked major coronary artery or branch (accessed through the skin)⚠ 4.7x markup
$129.6K
393 services$329.80/svc4.71x markup
92978Ultrasound evaluation of heart blood vessel or graft⚠ 4.3x markup
$126.0K
1.6K services$76.50/svc4.25x markup
93454Insertion of catheter for imaging of heart blood vessels or grafts⚠ 6.3x markup
$86.1K
781 services$110.27/svc6.27x markup
99232Subsequent hospital inpatient care, typically 25 minutes per day⚠ 3.1x markup
$84.5K
1.4K services$59.16/svc3.07x markup
99239Hospital discharge day management, more than 30 minutes⚠ 3.2x markup
$80.2K
907 services$88.46/svc3.16x markup
93459Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart⚠ 5.6x markup
$80.2K
467 services$171.67/svc5.61x markup
93456Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts⚠ 4.4x markup
$79.7K
381 services$209.27/svc4.39x markup
92933Removal of plaque and insertion of stent in major coronary artery or branch, accessed through the skin⚠ 3.7x markup
$79.5K
159 services$499.74/svc3.70x markup
92937Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin⚠ 4.2x markup
$78.7K
202 services$389.36/svc4.17x markup
99214Established patient office or other outpatient, visit typically 25 minutes⚠ 3.4x markup
$74.8K
878 services$85.19/svc3.38x markup
93571Ultrasound evaluation of heart blood vessel during diagnosis or treatment⚠ 3.6x markup
$70.0K
1.0K services$69.45/svc3.65x markup
93460Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart⚠ 4.8x markup
$60.1K
256 services$234.94/svc4.77x markup
99233Subsequent hospital inpatient care, typically 35 minutes per day
$58.6K
693 services$84.60/svc2.98x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
92928Catheter insertion of stents in major coronary artery or branch, accessed through the skin2.0K$763.2K$391.004.35x
33361Replacement of aortic valve with prosthetic valve, accessed through the skin760$494.2K$650.283.71x
93458Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart1.8K$283.5K$161.245.55x
92943Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin518$270.8K$522.753.63x
99223Initial hospital inpatient care, typically 70 minutes per day1.3K$217.9K$161.673.12x
99236Hospital observation or inpatient care high severity, 55 minutes per day1.1K$189.5K$175.833.28x
99204New patient office or other outpatient visit, typically 45 minutes1.1K$135.2K$117.733.67x
92920Balloon dilation of narrowed or blocked major coronary artery or branch (accessed through the skin)393$129.6K$329.804.71x
92978Ultrasound evaluation of heart blood vessel or graft1.6K$126.0K$76.504.25x
93454Insertion of catheter for imaging of heart blood vessels or grafts781$86.1K$110.276.27x
99232Subsequent hospital inpatient care, typically 25 minutes per day1.4K$84.5K$59.163.07x
99239Hospital discharge day management, more than 30 minutes907$80.2K$88.463.16x
93459Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart467$80.2K$171.675.61x
93456Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts381$79.7K$209.274.39x
92933Removal of plaque and insertion of stent in major coronary artery or branch, accessed through the skin159$79.5K$499.743.70x
92937Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin202$78.7K$389.364.17x
99214Established patient office or other outpatient, visit typically 25 minutes878$74.8K$85.193.38x
93571Ultrasound evaluation of heart blood vessel during diagnosis or treatment1.0K$70.0K$69.453.65x
93460Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart256$60.1K$234.944.77x
99233Subsequent hospital inpatient care, typically 35 minutes per day693$58.6K$84.602.98x

Markup Analysis

Charge-to-Payment Ratio

4.14x

This provider submits charges 4.14 times higher than what Medicare actually pays.

What This Means

A markup ratio of 4.14x means for every $100 Medicare pays, this provider initially charges $414. This is higher than the national average.

Location

La Jolla, CA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Interventional Cardiology providers in CA for peer comparison.

Paul Teirstein (you)
$3.7M
Moinakhtar Lala, M.D.
$43.9M
Mohamed Khan, M.D.
$42.2M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Moinakhtar Lala, M.D.Reseda, CA$43.9M✓ Clear
Mohamed Khan, M.D.Redding, CA$42.2M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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