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NPI 1235148727 · Atlanta, GA · Pediatric Cardiology Physician
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Childrens Healthcare Of Atlanta Cardiology Inc is a pediatric cardiology physician provider located in Atlanta, Georgia. This profile covers 0 Medicare and 43 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Childrens Healthcare Of Atlanta Cardiology Inc |
| Address | 2970 Brandywine Rd Ste 125 |
| City | Atlanta |
| State | GA |
| ZIP | 30341 |
| Taxonomy | Pediatric Cardiology Physician |
| NPI Enumerated | August 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $28.2M |
| Medicare | $0 |
CHILDRENS HEALTHCARE OF ATLANTA CARDIOLOGY INC is effectively a Medicaid-focused pediatric cardiology practice in Atlanta with $28.2M in total Medicaid revenue and no Medicare billing on file; its NPI has been enumerated since 2006-08-05 (~20 years ago), indicating long-standing participation in Medicaid networks. The absence of Medicare activity makes the provider functionally single-payer in scale for the data on file.
Revenue is materially concentrated in a small set of procedures: the precomputed top 3 Medicaid codes (93325, 99244, 93304) account for 37.2% of this provider's total Medicaid revenue. Those three codes individually report $4.8M (17.0% for 93325), $2.9M (10.2% for 99244) and $2.8M (10.0% for 93304), which identifies a narrow set of services driving more than one-third of Medicaid receipts.
The clinical mix is heavily weighted toward echocardiography and Doppler imaging, signaling an operations model built around high-volume cardiac diagnostics: 93325 shows 113.8K claims and $4.8M revenue, 93304 has 40.3K claims and $2.8M, and 93303 reports 27K claims and $2.6M. Those imaging codes (including add-on Doppler 93321 at 62.9K claims, $1.6M) indicate significant investment in ultrasound equipment, sonography staffing, and outpatient imaging throughput.
Alongside imaging, the practice reports substantial consultation and E/M volume consistent with complex outpatient management: 99244 has 16.8K claims and $2.9M revenue (ranked #1 in-state), 99214 has 21.8K claims and $2.0M, and 99213 has 16.5K claims and $1.1M. The prominence of higher-level consultation codes (99244 ranking #1 of 31 providers in-state at the 100th percentile, labeled an extreme outlier) suggests the provider manages a high-acuity pediatric cardiology referral population requiring longer visits and moderate-to-high decision-making.
The dataset also shows inpatient and critical-care pediatric cardiology activity, reflecting continuity across ambulatory and inpatient settings: 99472 (follow-up care of critically ill infants) has 7.1K claims and $2.7M revenue (9.7% of Medicaid revenue) and 99232 has 10.6K claims and $645.1K revenue. These volumes, together with reported E/M inpatient codes, indicate the provider handles a meaningful share of hospital-based pediatric cardiology follow-up and subsequent inpatient care.
Competitively, the provider is a statewide volume leader for core cardiac diagnostics and ECG services: 93325 ranks #1 of 21 providers in-state (100th percentile; extreme outlier), 93000 ranks #1 of 60 providers in-state (100th percentile; extreme outlier) with 87.2K claims and $2.3M revenue, and multiple other echo CPTs (93304, 93303, 93321, 93320) rank at or near the top of in-state lists. These rank/percentile signals position the organization as a dominant in-state provider for pediatric echo and ECG interpretation rather than a modest participant.
Operationally, the provider runs very high test and visit throughput: individual code claim volumes are large (e.g., 113.8K claims for 93325, 87.2K claims for 93000, 62.9K claims for 93321), while average paid-per-claim values for imaging and ECG codes are relatively modest (for example $42 avg for 93325 and $26 avg for 93000). This combination of high volume and low-to-moderate unit reimbursement implies revenue is driven by scale and requires robust scheduling, technician capacity, and reporting workflows to sustain current Medicaid revenue levels.
From a revenue-risk perspective, the practice’s dependence on Medicaid (no Medicare activity reported) and the fact that the top 3 codes concentrate 37.2% of Medicaid revenue suggest sensitivity to Medicaid policy, coverage, or rate changes for a small set of high-volume cardiac imaging and consultation codes. Analysts should view payer-policy shifts or changes to reimbursement for the named top codes (93325, 99244, 93304) as having outsized impact on this provider’s financial results.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
43 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 93325 | The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the… | 113,820 | $40 | $4.8M |
| 99244 | The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider… | 16,760 | $170 | $2.9M |
| 93304 | The provider performs a limited or follow–up transthoracic echocardiography to obtain images of the heart through the chest wall in patients born with heart defects. It is a limited examination of a… | 40,300 | $70 | $2.8M |
| 99472 | The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting. | 7,080 | $390 | $2.7M |
| 93303 | The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization… | 26,970 | $100 | $2.6M |
| 93000 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 87,190 | $30 | $2.3M |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 21,760 | $90 | $2M |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 12,440 | $160 | $2M |
| 93321 | The provider performs Doppler echocardiography using pulsed wave and/or continuous wave with a spectral display for a follow–up or limited study. The ultrasound involves the continuous generation of… | 62,900 | $30 | $1.6M |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 16,470 | $70 | $1.1M |
Showing 1–10 of 43
How this provider's Medicaid billing volume and revenue compare to other Georgia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Georgia median
43 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 93304 | The provider performs a limited or follow–up transthoracic echocardiography to obtain images of the heart through the chest wall in patients born with heart defects. It is a limited examination of a… | 1 | 10 | 200 | $80 | $709K |
| 93303 | The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization… | 1 | 10 | 250 | $130 | $636K |
| 99472 | The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting. | 1 | 10 | 190 | $370 | $561.3K |
| 93325 | The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the… | 1 | 20 | 890 | $60 | $498.3K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 66 | 920 | 370 | $60 | $360.6K |
| 76825 | The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system. | 7 | 10 | 730 | $240 | $348.7K |
| 71555 | In this diagnostic procedure, the provider performs a magnetic resonance angiography, or MRA, study of the blood vessels of the chest to evaluate for occlusion, stenosis, or aneurysm. The provider… | 2 | 10 | 80 | $1,220 | $261K |
| 93321 | The provider performs Doppler echocardiography using pulsed wave and/or continuous wave with a spectral display for a follow–up or limited study. The ultrasound involves the continuous generation of… | 1 | 10 | 120 | $40 | $245.8K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 34 | 820 | 390 | $70 | $245K |
| 93320 | The provider performs a complete Doppler echocardiography, which uses high–frequency sound waves to create a two–dimensional image of the heart, while the use of Doppler technology allows… | 1 | 10 | 520 | $50 | $240.4K |
Showing 1–10 of 43
Other providers in the same ZIP code as Childrens Healthcare Of Atlanta Cardiology Inc, ranked by combined Medicare and Medicaid revenue.
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