This provider's $13.2M in total Medicare payments ranks in the 99th percentile of Cardiology providers nationally.
Medicare payments to this provider grew 189% from 2014 to 2023.
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 | $347.36 | $78.87 | 4.40x | $268.49 | $827.5K | 13.6K | 8.6K |
| 2015 | $380.44 | $90.21 | 4.22x | $290.23 | $807.3K | 12.6K | 8.2K |
| 2016 | $390.76 | $93.26 | 4.19x | $297.50 | $948.5K | 13.2K | 9.1K |
| 2017 | $383.21 | $93.07 | 4.12x | $290.14 | $922.2K | 12.4K | 8.8K |
| 2018 | $412.38 | $102.04 | 4.04x | $310.34 | $905.8K | 12.2K | 8.9K |
| 2019 | $436.26 | $124.55 | 3.50x | $311.71 | $1.0M | 12.9K | 9.4K |
| 2020 | $404.58 | $121.26 | 3.34x | $283.32 | $1.4M | 11.7K | 9.4K |
| 2021 | $440.41 | $132.88 | 3.31x | $307.53 | $1.9M | 13.3K | 10.0K |
| 2022 | $556.55 | $179.29 | 3.10x | $377.26 | $2.0M | 12.0K | 9.6K |
| 2023 | $535.38 | $151.53 | 3.53x | $383.85 | $2.4M | 11.3K | 9.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78431 | Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan | 995 | $1.9M | $1.9K | 1.90x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 21.2K | $1.8M | $82.80 | 2.75x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 4.3K | $1.7M | $387.65 | 6.19x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 11.0K | $1.5M | $140.20 | 5.61x |
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 1.1K | $1.4M | $1.2K | 1.30x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 2.1K | $1.3M | $621.01 | 1.90x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 724 | $434.7K | $600.35 | 3.24x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 6.6K | $388.9K | $59.08 | 4.47x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.3K | $355.9K | $107.32 | 2.88x |
| 78434 | Nuclear medicine absolute quantification of blood flow in heart muscle | 1.6K | $245.1K | $149.44 | 7.96x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 4.0K | $232.0K | $57.30 | 2.81x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 17.8K | $216.6K | $12.13 | 5.11x |
| J2785 | Injection, regadenoson, 0.1 mg | 4.7K | $209.8K | $44.86 | 2.95x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 2.4K | $157.8K | $64.85 | 12.14x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 869 | $132.9K | $152.92 | 2.86x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $129.7K | $120.05 | 2.97x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.1K | $116.2K | $103.31 | 2.91x |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 1.8K | $97.2K | $52.88 | 14.82x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 571 | $86.3K | $151.22 | 2.96x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 909 | $74.7K | $82.13 | 2.80x |
This provider submits charges 3.63 times higher than what Medicare actually pays.
A markup ratio of 3.63x means for every $100 Medicare pays, this provider initially charges $363. 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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