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NPI 1427050285 · Christiansted, VI · Cardiovascular Disease Physician
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Michael Rubin is a cardiovascular disease physician provider located in Christiansted, U.S. Virgin Islands. This profile covers 9 Medicare and 22 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 | Individual |
| Organization | Michael Rubin |
| Address | 4100 Sion Farm Shopp Ctr Ste 8 |
| City | Christiansted |
| State | VI |
| ZIP | 00820 |
| Taxonomy | Cardiovascular Disease Physician |
| NPI Enumerated | August 11, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $557.5K |
| Medicare | $160.7K |
Provider tenure and specialty: MICHAEL RUBIN has an NPI enumerated 2005-08-11 (~21 years ago), indicating long-standing enrollment and sustained activity as a Cardiovascular Disease Physician serving CHRISTIANSTED, VI. The code mix across both payers (high-complexity E/M plus cardiac imaging and vascular diagnostics) is consistent with an established cardiology outpatient practice that also performs onsite diagnostic testing.
Payer-scale and mix: This provider’s Medicaid revenue ($557.5K) is substantially larger than Medicare revenue ($160.7K), indicating a Medicaid-dominant revenue footprint rather than a Medicare-focused practice. Both payers show meaningful procedural and E/M billing, but Medicaid represents the larger share of lifetime billing on file.
Medicare revenue concentration: The top 3 Medicare codes account for 85.2% of the provider’s total Medicare revenue, driven primarily by 99215 ($101.7K, 63.3%), 93306 ($22.9K, 14.3%), and 99205 ($12.3K, 7.7%). This concentration signals that complex established and new outpatient E/M visits plus transthoracic echocardiography are the primary Medicare revenue drivers for the practice.
Medicaid revenue concentration: The top 3 Medicaid codes account for 77.2% of the provider’s total Medicaid revenue, led by 99214 ($200K, 35.9%), 99354 ($169.6K, 30.4%), and 93306 ($60.6K, 10.9%). High shares for 99214 and 99354 point to heavy billing for moderate-complexity established visits and prolonged services under Medicaid, with echocardiography also a significant contributor.
Business and services implications: Dominant use of E/M codes 99215, 99205 (Medicare) and 99214, 99204 (Medicaid) combined with substantial 93306 and vascular study codes (e.g., 93922, 93880) suggests the practice operates as an outpatient cardiology clinic that pairs comprehensive clinician visits with on-site diagnostic imaging and noninvasive vascular testing. The presence of both high-complexity visits and technical/interpretive cardiovascular procedures supports a service line that mixes ambulatory cardiology consultations and diagnostic throughput.
Medicare competitive standing: For Medicare 99215 the provider ranks #478 of 145531 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), indicating nationally exceptional volume for that code. Other Medicare codes are more typical: 93306 ranks #14676 of 24624 (40th percentile; typical) while 93000 ranks #2701 of 71016 (96th percentile; notably above typical national volume for this code), showing pockets of above-average activity in cardiac diagnostics.
Medicaid competitive standing: Within the state Medicaid pool the provider is a leading biller for several top codes: 99354 ranks #1 of 4 providers in-state (100th percentile; typical, unremarkable volume for this code) and 99214 ranks #14 of 43 providers in-state (69th percentile; typical, unremarkable volume for this code). Vascular diagnostics are notable in Medicaid as well—93922 contributed $53.6K (9.6% of Medicaid revenue) and ranks #2 of 2 in-state—indicating the provider is a meaningful local source for physiologic arterial studies.
Unpaid/zero-paid Medicaid claim patterns: The Medicaid code list includes multiple high-count vaccine and preventive counseling codes (e.g., 90686, 90662, 99402, 90670) showing large claim volumes but $0 avg paid/claim and $0 revenue in the file. This pattern is data-grounded and may reflect payer-specific payment rules, bundled payment arrangements, or reporting practices rather than absence of service; it is an important reporting characteristic to consider when reconciling billed activity with recorded revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 830 | $120 | $101.7K |
| 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… | 170 | $140 | $22.9K |
| 99205 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider… | 80 | $150 | $12.3K |
| 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… | 750 | $10 | $8.3K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 70 | $90 | $5.9K |
| 93975 | The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs… | 20 | $200 | $3.2K |
| 93880 | Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral… | 20 | $150 | $3.2K |
| 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… | 40 | $60 | $2.2K |
| 76775 | A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. Kidneys, urinary bladder, and aorta). This particular CPT code is used when the… | 20 | $50 | $1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
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Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
22 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,680 | $120 | $200K |
| 99354 | N/A | 1,320 | $130 | $169.6K |
| 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… | 530 | $120 | $60.6K |
| 93922 | Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral | 650 | $80 | $53.6K |
| 99204 | The provider sees a new 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 provider… | 200 | $160 | $31.5K |
| 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… | 1,060 | $10 | $14.9K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 1,670 | $10 | $13.3K |
| 93224 | In this procedure, the provider applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to detect abnormal heart rates and rhythms. He analyzes, compiles, and interprets the… | 110 | $70 | $8.2K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 70 | $40 | $3.3K |
| 93880 | Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral… | 10 | $210 | $2.5K |
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How this provider's Medicaid billing volume and revenue compare to other U.S. Virgin Islands providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. U.S. Virgin Islands median
22 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 14 | 40 | 560 | $140 | $322K |
| 93922 | Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral | 2 | 10 | 2,470 | $80 | $185.4K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 13 | 20 | 200 | $150 | $93.5K |
| 99354 | N/A | 1 | 10 | 730 | $130 | $92.6K |
| 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… | 3 | 10 | 510 | $160 | $73.8K |
| J3490 | Unclassified drugs | 2 | 10 | 1,020 | $60 | $63.4K |
| 99204 | The provider sees a new 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 provider… | 4 | 30 | 80 | $150 | $27K |
| 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… | 3 | 10 | 750 | $20 | $21.2K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 2 | 10 | 2,480 | $10 | $12.9K |
| 93224 | In this procedure, the provider applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to detect abnormal heart rates and rhythms. He analyzes, compiles, and interprets the… | 1 | 10 | 110 | $70 | $8.3K |
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Other providers in the same ZIP code as Michael Rubin, ranked by combined Medicare and Medicaid revenue.
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