Loading...
NPI 1427320399 · Pleasanton, CA · Physiological Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Cardionet, LLC. is a physiological laboratory provider located in Pleasanton, California. This profile covers 6 Medicare and 10 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 | Cardionet, LLC. |
| Address | 4430 Rosewood Dr Ste 200 |
| City | Pleasanton |
| State | CA |
| ZIP | 94588 |
| Taxonomy | Physiological Laboratory |
| NPI Enumerated | February 7, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $112.2M |
| Medicaid | $1M |
CARDIONET, LLC. (Physiological Laboratory, Pleasanton, CA) bills predominantly for ambulatory cardiac monitoring services: the Medicare and Medicaid top codes are dominated by wearable/event ECG monitoring procedures (93229, 93271 and related ECG recording/analysis codes) and a home INR materials code (G0249). The code mix and descriptions indicate a service-line focused on placing, monitoring and analyzing wearable cardiac monitors and processing transmitted ECG data rather than in‑person diagnostic or treatment encounters.
Medicare revenue is highly concentrated: the provider reported $112.2M in total Medicare revenue and its top three Medicare codes account for 99.9% of that Medicare revenue. The largest driver is 93229 ($103.1M, 92.0% of Medicare revenue), followed by G0249 ($6.5M, 5.8%) and 93271 ($2.4M, 2.2%), showing near-total dependence on a very small set of remote monitoring services.
Medicaid revenue is similarly focused but on a much smaller scale: total Medicaid revenue is $1M with the top three Medicaid codes accounting for 97.9% of that amount. The principal Medicaid drivers are 93229 ($905.8K, 89.5% of Medicaid revenue), 93271 ($47.1K, 4.7%), and G0249 ($38.5K, 3.8%), indicating the same remote cardiac monitoring service-line is the core Medicaid offering.
The provider’s payer mix is heavily Medicare-skewed: reported Medicare revenue of $112.2M dwarfs Medicaid revenue of $1M, so CARDIONET operates effectively as a Medicare-dominated business in scale and financial exposure. This concentration implies revenue and reimbursement risk is tied chiefly to Medicare policy and coverage for ambulatory cardiac monitoring.
CARDIONET’s competitive standing on its core Medicare codes is exceptional: it ranks #1 of 2091 nationally for 93229 (100th percentile; extreme outlier) and #1 of 34 for 93271 (100th percentile; extreme outlier), while G0249 ranks #3 of 65 (97th percentile; typical, unremarkable volume). Those ranks characterize the provider as a national leader and outlier for wearable ECG monitoring volume and revenue, substantially above typical national peers for the same services.
State-level Medicaid comparisons mirror the national pattern for its flagship code: 93229 ranks #2 of 85 in-state (99th percentile; extreme outlier), while 93271 ranks #3 of 16 (87th percentile; typical, unremarkable) and G0249 ranks #4 of 6 (40th percentile; typical, unremarkable). This indicates dominant state-level volume for the primary wearable monitoring service, with more modest or mixed standing for ancillary monitoring and supply codes.
CARDIONET has an established operational tenure, with its NPI enumerated on 2012-02-07 (~14 years ago), consistent with a mature specialized monitoring service likely built to scale over time. The long enumeration period aligns with the provider’s outsized volumes in remote monitoring codes and suggests sustained focused operations rather than a recent rapid entry.
Beyond the two revenue giants, remaining listed ECG and device-management codes contribute minimal revenue relative to the core services (examples include Medicare 93226 at $39K revenue and 93270 at $25.2K revenue, and Medicaid 93243 at $10.5K revenue). This pattern reinforces that CARDIONET’s business model centers on high-volume remote monitoring for which it is an extreme outlier, while other related technical/reporting codes play a much smaller supporting role.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 93229 | In this procedure, the provider, typically a technician, places a wearable electrocardiographic monitoring device on the patient, instructs him in its use, and monitors the transmissions, to detect… | 113,820 | $910 | $103.1M |
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage… | 97,000 | $70 | $6.5M |
| 93271 | In this service, the provider monitors the patient’s heart rhythm while the patient is experiencing cardiac symptoms. He places electrocardiogram leads of an event recorder on the patient's chest,… | 15,900 | $150 | $2.4M |
| 93226 | The physician or other healthcare professional applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to help detect abnormal heart rates and rhythms. This service reports… | 1,060 | $40 | $39K |
| 93270 | In this service, the provider monitors the patient’s heart rhythm while the patient is experiencing cardiac symptoms. He places electrocardiogram leads of an event recorder on the patient's chest,… | 4,190 | $10 | $25.2K |
| 93225 | The physician or other healthcare professional applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to help detect abnormal heart rates and rhythms. This service reports… | 30 | $10 | $370 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 93229 | In this procedure, the provider, typically a technician, places a wearable electrocardiographic monitoring device on the patient, instructs him in its use, and monitors the transmissions, to detect… | 13,320 | $70 | $905.8K |
| 93271 | In this service, the provider monitors the patient’s heart rhythm while the patient is experiencing cardiac symptoms. He places electrocardiogram leads of an event recorder on the patient's chest,… | 2,360 | $20 | $47.1K |
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage… | 4,810 | $10 | $38.5K |
| 93243 | After a patient has worn an electrocardiographic, or ECG recorder, for more than 48 hours, up to 7 days, to detect abnormal heart rates and rhythm, a processing center technician performs a scanning… | 620 | $20 | $10.5K |
| 93247 | After a patient has worn an electrocardiographic, or ECG recorder, for more than seven days, up to 15 days, to detect abnormal heart rates and rhythm, a processing center technician performs a… | 220 | $40 | $8.2K |
| 93226 | The physician or other healthcare professional applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to help detect abnormal heart rates and rhythms. This service reports… | 190 | $10 | $1.7K |
| 93270 | In this service, the provider monitors the patient’s heart rhythm while the patient is experiencing cardiac symptoms. He places electrocardiogram leads of an event recorder on the patient's chest,… | 120 | $10 | $590 |
| 93296 | The technician gathers data, for a period of up to 90 days, from a patient’s single, dual, multiple lead, or leadless pacemaker system or implantable defibrillator system by remotely accessing the… | 280 | $0 | $0 |
| 93297 | The provider, who is a physician or other qualified healthcare professional, evaluates the physiologic data from the implantable physiologic cardiovascular monitoring system during a period of up 30… | 710 | $0 | $0 |
| 93298 | The provider, who is a physician or other qualified healthcare professional, evaluates the data from a previously implanted subcutaneous cardiac rhythm monitor system via telemetric communication for… | 260 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage… | 4 | 10 | 5,370 | $20 | $726.9K |
| 93247 | After a patient has worn an electrocardiographic, or ECG recorder, for more than seven days, up to 15 days, to detect abnormal heart rates and rhythm, a processing center technician performs a… | 12 | 20 | 520 | $70 | $563.9K |
| 93229 | In this procedure, the provider, typically a technician, places a wearable electrocardiographic monitoring device on the patient, instructs him in its use, and monitors the transmissions, to detect… | 2 | 90 | 300 | $400 | $456.7K |
| 93243 | After a patient has worn an electrocardiographic, or ECG recorder, for more than 48 hours, up to 7 days, to detect abnormal heart rates and rhythm, a processing center technician performs a scanning… | 5 | 10 | 450 | $60 | $365.2K |
| 93271 | In this service, the provider monitors the patient’s heart rhythm while the patient is experiencing cardiac symptoms. He places electrocardiogram leads of an event recorder on the patient's chest,… | 3 | 20 | 230 | $40 | $38.2K |
| 93226 | The physician or other healthcare professional applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to help detect abnormal heart rates and rhythms. This service reports… | 22 | 40 | 210 | $30 | $29.3K |
| 93298 | The provider, who is a physician or other qualified healthcare professional, evaluates the data from a previously implanted subcutaneous cardiac rhythm monitor system via telemetric communication for… | 26 | 70 | 140 | $30 | $25K |
| 93296 | The technician gathers data, for a period of up to 90 days, from a patient’s single, dual, multiple lead, or leadless pacemaker system or implantable defibrillator system by remotely accessing the… | 68 | 140 | 280 | $20 | $14K |
| 93297 | The provider, who is a physician or other qualified healthcare professional, evaluates the physiologic data from the implantable physiologic cardiovascular monitoring system during a period of up 30… | 31 | 110 | 240 | $10 | $10.3K |
| 93270 | In this service, the provider monitors the patient’s heart rhythm while the patient is experiencing cardiac symptoms. He places electrocardiogram leads of an event recorder on the patient's chest,… | 6 | 20 | 50 | $30 | $5.4K |
Other providers in the same ZIP code as Cardionet, LLC., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Axis Community Health Inc | CA | Community Health Clinic/Center | $0 | $50.7M |
| Team Physicians Of Northern California Medical Group Inc | CA | Emergency Medicine Physician | $0 | $27M |
| Amita Saggi | CA | Physician Assistant | $2.1M | $0 |
| Minh Dang | CA | Dermatology Physician | $1.2M | $0 |
| Hacienda Outpatient Surgery Center, LLC | CA | Ambulatory Surgical Clinic/Center | $1.1M | $0 |
| Ramford Ng | CA | Cardiovascular Disease Physician | $607.7K | $0 |
| Young Kang | CA | Specialist | $411.2K | $0 |
| Saba Lahsaei | CA | Internal Medicine Physician | $372.4K | $0 |
| Joseph Grant | CA | Orthopaedic Surgery of the Spine Physician | $253.7K | $0 |
| Hank Fung | CA | Dermatology Physician | $213.3K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.