This provider's $6.9M in total Medicare payments ranks in the 99th percentile of Cardiology providers nationally.
Their average markup ratio of 8.8x is significantly above the specialty median of 3.6x.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 72% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $782.27 | $100.81 | 7.76x | $681.46 | $662.4K | 7.4K | 5.1K |
| 2015 | $801.90 | $102.08 | 7.86x | $699.82 | $731.4K | 7.8K | 5.4K |
| 2016 | $753.06 | $97.25 | 7.74x | $655.81 | $688.2K | 7.6K | 5.1K |
| 2017 | $763.42 | $91.00 | 8.39x | $672.42 | $569.7K | 6.4K | 4.3K |
| 2018 | $801.48 | $94.66 | 8.47x | $706.82 | $680.2K | 7.3K | 5.2K |
| 2019 | $847.48 | $104.50 | 8.11x | $742.98 | $353.2K | 4.2K | 2.7K |
| 2020 | $2.2K | $388.21 | 5.75x | $1.8K | $545.8K | 5.3K | 3.8K |
| 2021 | $1.7K | $294.96 | 5.65x | $1.4K | $936.3K | 9.0K | 5.9K |
| 2022 | $1.7K | $253.58 | 6.75x | $1.5K | $847.1K | 10.3K | 6.6K |
| 2023 | $1.7K | $250.60 | 6.98x | $1.5K | $932.8K | 10.7K | 7.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 23.6K | $2.0M | $85.47 | 8.38x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 4.4K | $1.7M | $395.13 | 4.18x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 6.7K | $1.1M | $170.95 | 10.74x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 4.4K | $430.9K | $97.38 | 17.79x |
| 33285 | Insertion of heart rhythm monitor under skin | 76 | $319.9K | $4.2K | 5.35x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 4.6K | $245.2K | $53.30 | 13.92x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 3.8K | $243.9K | $63.76 | 22.33x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 17.5K | $214.9K | $12.29 | 13.04x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $148.6K | $125.40 | 6.43x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 827 | $117.6K | $142.14 | 6.31x |
| J2785 | Injection, regadenoson, 0.1 mg | 1.5K | $66.1K | $44.02 | 6.14x |
| 93356 | Heart muscle strain imaging | 1.6K | $52.1K | $32.09 | 6.24x |
| G2066 | Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and tec | 1.4K | $48.5K | $34.84 | 4.90x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 203 | $41.6K | $204.71 | 4.01x |
| 93298 | Remote evaluations of heart rhythm monitor system implanted under skin with qualified health care professional analysis, review, and report, up to 30 days | 1.4K | $27.9K | $19.93 | 7.32x |
| 99406 | Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes | 1.1K | $18.4K | $16.03 | 3.12x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 88 | $15.1K | $171.47 | 5.15x |
| 93288 | Evaluation of parameters of single, dual, or multiple lead pacemaker including device connection, recording, and disconnection | 390 | $12.1K | $31.01 | 7.05x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 58 | $9.4K | $161.38 | 4.76x |
| 93289 | Evaluation of defibrillator including connection, recording and disconnection | 179 | $9.0K | $50.46 | 6.38x |
This provider submits charges 8.8 times higher than what Medicare actually pays.
A markup ratio of 8.8x means for every $100 Medicare pays, this provider initially charges $880. 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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