Cardiology
Revenue intelligence for Cardiology practices. CCM and RPM benchmarks, E&M coding data, and heart failure management revenue opportunities.
$143K
Avg Missed/Year
29K
US Providers
520
Avg Patients
3.8
Avg Chronic Dx
Specialty Overview
Cardiology practices manage the highest-acuity Medicare patients, with an average HCC risk score of 1.55 and 78% hypertension prevalence. This creates outsized opportunities in CCM and RPM — particularly for heart failure and hypertension monitoring programs. Cardiology also has the highest justified 99215 usage of any specialty.
Key Insight: Cardiology has the highest per-provider missed revenue ($142K) of any specialty, driven by the combination of high-acuity patients and strong CCM/RPM eligibility. Heart failure RPM programs alone can generate $100K+ annually.
E&M Coding Distribution
National benchmark for Cardiology E&M code distribution. Compare your practice against these targets to identify coding optimization opportunities.
99213
20%
$92/visit
99214
50%
$130/visit
99215
30%
$176/visit
Revenue Gap Breakdown
E&M Coding Gap
Cardiology benchmarks show 30% of visits should be 99215, but many practices undercode. With $176 per 99215, each shifted visit adds significant revenue.
CCM (99490)
18% adoption rate but 78% of patients have hypertension and 35% have heart failure. The eligible CCM pool in cardiology is massive — 200+ patients per practice.
RPM (99453-99458)
At 12%, cardiology leads RPM adoption but still has enormous room to grow. Blood pressure and weight monitoring for heart failure patients is clinically compelling and highly reimbursable.
AWV (G0438/G0439)
15% AWV rate reflects the specialist focus, but AWV-eligible patients should still be identified and referred or co-managed.
BHI (99484)
Depression prevalence of 15% in cardiac patients is often under-recognized. Cardiac rehabilitation plus BHI is an emerging revenue stream.
Care Management Adoption Rates
CCM
18%
Target: 15%
RPM
12%
Target: 10%
BHI
3%
Target: 10%
AWV
15%
Target: 70%
Common Chronic Conditions
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Cardiology Provider? See Your Gaps
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