How much is denial leakage costing your practice?
Enter three numbers. See the annual revenue your practice is losing to denied claims, measured against real specialty benchmarks. Shareable, no email required.
Your practice
Cardiology context
Cardiology runs hot on denials due to pre-authorization gates on cath, stress imaging, and interventional procedures. Bundling edits on multi-vessel PCI and global-period claims add volume.
Annual revenue at risk
Based on your volume, your denial rate, and the typical cardiology claim value.
Projected annual denial dollars
$571,200
1,344 claims denied per year × average $425 per claim.
Annual gross billed
$4,080,000
800 claims/mo × 12 × avg claim
Denied claims/year
1,344
14.0% of annual volume
Vs Cardiology benchmark
$20,400/year above the cardiology benchmark
A practice with your volume at the cardiology industry denial rate would lose $550,800/year. You’re losing $20,400 more than that. Specialty-aware billing typically closes this gap.
Recoverable with proper appeals
Not every denial is recoverable. Published MGMA benchmarks show high-performing billing operations appeal and overturn roughly 65% of denied dollars when claims are worked systematically and filed within payer deadlines.
Recoverable at 65% appeal-success rate
$371,280
Per year, with specialty-aware billing + aggressive workflow.
Top recoverable denial categories in Cardiology
If you audit your last 90 days of cardiology denials, these categories will dominate the recoverable-dollars list.
- 1Prior-auth (CO-197)
- 2Bundling (CO-97)
- 3Medical necessity (CO-50)
Transparent methodology
Annual revenue at risk
monthly_volume × denial_rate × 12 × avg_claim_value
Benchmark comparison
Per-specialty benchmark denial rates are weighted estimates from MGMA 2024 and Change Healthcare 2024 denial reports. Industry average is 11.8%.
Recoverable estimate
65% of denied dollars are achievable for practices running appeals systematically under payer deadlines. Real-world overturn rates vary by CARC category and documentation quality.
Average claim values
Specialty-weighted averages of typical professional-fee claim mixes. Your practice’s actual average may differ. A free audit replaces these estimates with your real numbers.
This calculator is a directional estimator, not a formal financial analysis. Individual practice economics vary by payer mix, contract rates, and coding accuracy. For an exact figure on your practice’s specific leakage, request a free denial audit. Our team produces a written report from your actual 90-day claims data.
Turn the leakage number into a recovery number
Our AR team audits your last 90 days of denials, surfaces recoverable lines, and files appeals. AAPC-certified coders. 2.49 percent of collections. No setup fees.