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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. Rajiv Agarwal
❤️
MDIndividual

Rajiv Agarwal, MD

NPI: 1649486168
Humble, TX
10 years of data
Cardiology
$16.6M
Total Payments
342
Beneficiaries
375.4K
Services
4.09x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$16.6M
Specialty median$193.1K

📋 Key Findings

1Billed $16.6M over 10 years
24.09x markup ratio (above median)
399th percentile in Cardiology by payments
4150 services/day — unusually high
5Payments surged 113% in 2020
619 procedures with >3x markup

This provider averages 150 services per working day

Based on 375.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $16.6M in total Medicare payments ranks in the 99th percentile of Cardiology providers nationally.

Averaging 150 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 601% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 113% in 2020

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

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$57.72$12.514.61x$45.21$464.5K37.1K31
2015$63.97$13.194.85x$50.78$517.8K39.2K31
2016$69.32$14.554.76x$54.77$430.4K29.6K31
2017$76.74$19.843.87x$56.90$631.0K31.8K28
2018$131.15$37.633.49x$93.52$794.0K21.1K40
2019$569.07$156.083.65x$412.99$1.0M6.5K20
2020$182.02$44.154.12x$137.87$2.2M49.1K33
2021$276.02$66.134.17x$209.89$3.5M53.1K41
2022$269.04$66.504.05x$202.54$3.8M57.8K46
2023$265.04$65.174.07x$199.87$3.3M50.0K41

Top Procedures (20)

78431Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan⚠ 3.8x markup
$4.4M
2.3K services$1.9K/svc3.79x markup
A9555Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries
$2.0M
3.3K services$611.87/svc2.39x markup
93229Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional⚠ 3.5x markup
$1.6M
2.6K services$620.19/svc3.55x markup
99214Established patient office or other outpatient visit, 30-39 minutes⚠ 3.5x markup
$1.3M
14.6K services$89.49/svc3.46x markup
78492Multiple nuclear medicine studies of blood flow in heart muscle at rest and with stress⚠ 3.8x markup
$958.0K
930 services$1.0K/svc3.82x markup
J2785Injection, regadenoson, 0.1 mg⚠ 9.8x markup
$686.7K
15.1K services$45.36/svc9.82x markup
36482Chemical destruction of first incompetent vein of arm or leg using imaging guidance⚠ 4.0x markup
$580.0K
388 services$1.5K/svc3.99x markup
93306Ultrasound of heart with color-depicted blood flow, rate, direction and valve function⚠ 4.6x markup
$541.4K
4.1K services$133.52/svc4.61x markup
78452Nuclear medicine studies of heart muscle at rest and with stress and spect⚠ 4.9x markup
$417.0K
1.1K services$367.74/svc4.92x markup
36465Injection of chemical agent into single incompetent vein of leg using ultrasound guidance⚠ 4.1x markup
$386.4K
332 services$1.2K/svc4.07x markup
78434Nuclear medicine study of heart muscle blood flow by pet⚠ 5.1x markup
$334.5K
2.3K services$147.90/svc5.07x markup
99204New patient office or other outpatient visit, 45-59 minutes⚠ 3.9x markup
$256.3K
2.1K services$122.35/svc3.91x markup
93925Ultrasound of leg arteries or artery grafts⚠ 4.2x markup
$247.0K
1.3K services$190.47/svc4.17x markup
93880Ultrasound of both sides of head and neck blood flow⚠ 4.5x markup
$238.8K
1.7K services$139.24/svc4.48x markup
93015Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician⚠ 6.7x markup
$230.6K
4.4K services$52.89/svc6.71x markup
93970Ultrasound study of arm or leg veins with compression and maneuvers⚠ 4.6x markup
$228.7K
1.7K services$133.36/svc4.57x markup
G0166External counterpulsation, per treatment session⚠ 3.6x markup
$213.7K
2.4K services$88.69/svc3.61x markup
75574Ct scan of blood vessels and grafts of heart with contrast⚠ 5.9x markup
$213.2K
863 services$247.01/svc5.88x markup
74174Ct scan of blood vessels of abdomen and pelvis with contrast⚠ 4.7x markup
$167.3K
550 services$304.13/svc4.68x markup
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes⚠ 3.5x markup
$158.0K
2.7K services$57.75/svc3.47x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
78431Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan2.3K$4.4M$1.9K3.79x
A9555Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries3.3K$2.0M$611.872.39x
93229Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional2.6K$1.6M$620.193.55x
99214Established patient office or other outpatient visit, 30-39 minutes14.6K$1.3M$89.493.46x
78492Multiple nuclear medicine studies of blood flow in heart muscle at rest and with stress930$958.0K$1.0K3.82x
J2785Injection, regadenoson, 0.1 mg15.1K$686.7K$45.369.82x
36482Chemical destruction of first incompetent vein of arm or leg using imaging guidance388$580.0K$1.5K3.99x
93306Ultrasound of heart with color-depicted blood flow, rate, direction and valve function4.1K$541.4K$133.524.61x
78452Nuclear medicine studies of heart muscle at rest and with stress and spect1.1K$417.0K$367.744.92x
36465Injection of chemical agent into single incompetent vein of leg using ultrasound guidance332$386.4K$1.2K4.07x
78434Nuclear medicine study of heart muscle blood flow by pet2.3K$334.5K$147.905.07x
99204New patient office or other outpatient visit, 45-59 minutes2.1K$256.3K$122.353.91x
93925Ultrasound of leg arteries or artery grafts1.3K$247.0K$190.474.17x
93880Ultrasound of both sides of head and neck blood flow1.7K$238.8K$139.244.48x
93015Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician4.4K$230.6K$52.896.71x
93970Ultrasound study of arm or leg veins with compression and maneuvers1.7K$228.7K$133.364.57x
G0166External counterpulsation, per treatment session2.4K$213.7K$88.693.61x
75574Ct scan of blood vessels and grafts of heart with contrast863$213.2K$247.015.88x
74174Ct scan of blood vessels of abdomen and pelvis with contrast550$167.3K$304.134.68x
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2.7K$158.0K$57.753.47x

Markup Analysis

Charge-to-Payment Ratio

4.09x

This provider submits charges 4.09 times higher than what Medicare actually pays.

What This Means

A markup ratio of 4.09x means for every $100 Medicare pays, this provider initially charges $409. This is higher than the national average.

Location

Humble, TX

Provider Verification

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

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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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