This provider's $4.2M in total Medicare payments ranks in the 98th percentile of Interventional Cardiology providers nationally.
Their average markup ratio of 5.1x is significantly above the specialty median of 4.0x.
Medicare payments to this provider grew 371% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 181% in 2022
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 | $400.92 | $90.99 | 4.41x | $309.93 | $248.6K | 4.0K | 3.3K |
| 2015 | $462.06 | $104.80 | 4.41x | $357.26 | $243.4K | 4.0K | 3.3K |
| 2016 | $415.08 | $85.17 | 4.87x | $329.91 | $201.5K | 3.4K | 2.9K |
| 2017 | $488.82 | $101.09 | 4.84x | $387.73 | $203.8K | 3.2K | 2.8K |
| 2018 | $854.30 | $155.62 | 5.49x | $698.68 | $253.7K | 3.4K | 3.0K |
| 2019 | $830.37 | $150.73 | 5.51x | $679.64 | $236.0K | 3.0K | 2.8K |
| 2020 | $527.62 | $92.37 | 5.71x | $435.25 | $166.3K | 2.6K | 2.4K |
| 2021 | $669.67 | $150.64 | 4.45x | $519.03 | $376.5K | 4.0K | 3.7K |
| 2022 | $761.88 | $202.64 | 3.76x | $559.24 | $1.1M | 4.6K | 4.2K |
| 2023 | $656.18 | $164.56 | 3.99x | $491.62 | $1.2M | 4.5K | 4.0K |
| 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 | 950 | $1.3M | $1.4K | 3.85x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 6.2K | $565.7K | $90.83 | 12.19x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.3K | $521.8K | $83.11 | 2.79x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 953 | $330.2K | $346.49 | 1.91x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.0K | $172.9K | $85.95 | 2.76x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 1.7K | $172.4K | $100.49 | 5.80x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.3K | $136.2K | $59.71 | 2.73x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.1K | $123.3K | $111.43 | 2.47x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 733 | $120.4K | $164.26 | 2.50x |
| 33361 | Replacement of aortic valve with prosthetic valve, accessed through the skin | 143 | $101.5K | $709.82 | 6.10x |
| 93018 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report | 7.2K | $80.0K | $11.12 | 25.02x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 667 | $65.6K | $98.37 | 3.36x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 220 | $50.1K | $227.87 | 4.51x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 257 | $47.7K | $185.52 | 3.49x |
| 92928 | Catheter insertion of stents in major coronary artery or branch, accessed through the skin | 95 | $43.5K | $457.45 | 4.39x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 752 | $43.3K | $57.54 | 2.87x |
| 33418 | Replacement of aortic valve with prosthetic valve accessed through the skin | 31 | $39.0K | $1.3K | 5.49x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 170 | $27.3K | $160.60 | 2.49x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 191 | $23.0K | $120.35 | 3.22x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 234 | $19.8K | $84.42 | 2.74x |
This provider submits charges 5.1 times higher than what Medicare actually pays.
A markup ratio of 5.1x means for every $100 Medicare pays, this provider initially charges $510. 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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