This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Cardiac Surgery 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 | $161.77 | $103.55 | 1.56x | $58.22 | $550.5K | 6.7K | 4.1K |
| 2015 | $223.02 | $115.12 | 1.94x | $107.90 | $481.7K | 5.2K | 3.5K |
| 2016 | $247.45 | $110.53 | 2.24x | $136.92 | $558.3K | 6.9K | 4.4K |
| 2017 | $261.96 | $111.02 | 2.36x | $150.94 | $494.7K | 6.7K | 4.0K |
| 2018 | $245.32 | $107.18 | 2.29x | $138.14 | $385.0K | 5.3K | 3.3K |
| 2019 | $235.97 | $104.94 | 2.25x | $131.03 | $438.6K | 5.9K | 3.8K |
| 2020 | $246.48 | $109.30 | 2.26x | $137.18 | $496.8K | 5.9K | 3.4K |
| 2021 | $263.46 | $113.47 | 2.32x | $149.99 | $500.5K | 5.9K | 3.4K |
| 2022 | $254.59 | $108.55 | 2.35x | $146.04 | $503.5K | 6.1K | 3.8K |
| 2023 | $270.90 | $116.84 | 2.32x | $154.06 | $491.5K | 5.7K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 18.4K | $1.6M | $87.25 | 1.66x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.9K | $616.3K | $156.47 | 2.02x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 1.1K | $449.2K | $409.51 | 1.64x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 1.7K | $292.5K | $169.28 | 1.64x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.0K | $235.7K | $118.07 | 1.71x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.5K | $205.8K | $83.95 | 1.62x |
| 93351 | Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report | 894 | $187.1K | $209.31 | 2.24x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.0K | $167.2K | $164.11 | 1.73x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 788 | $123.2K | $156.32 | 1.69x |
| 92928 | Catheter insertion of stents in major coronary artery or branch, accessed through the skin | 262 | $120.3K | $459.30 | 1.79x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 9.4K | $118.9K | $12.71 | 3.27x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 406 | $73.4K | $180.79 | 4.77x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 604 | $60.1K | $99.58 | 2.51x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 1.1K | $59.7K | $54.34 | 2.46x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 302 | $57.2K | $189.48 | 1.31x |
| 93978 | Ultrasound scan of vena cava or groin graft or vessel blood flow | 280 | $45.1K | $161.01 | 1.84x |
| 93320 | Doppler ultrasound study of heart blood flow, valves, and chambers | 892 | $41.4K | $46.39 | 2.62x |
| J2785 | Injection, regadenoson, 0.1 mg | 924 | $41.2K | $44.60 | 2.24x |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 480 | $40.2K | $83.65 | 2.11x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 333 | $40.0K | $119.99 | 1.75x |
This provider submits charges 1.94 times higher than what Medicare actually pays.
A markup ratio of 1.94x means for every $100 Medicare pays, this provider initially charges $194. This is lower 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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