Medicare Enrolled

Dr. Prashant Upadhyaya, MD

Surgery · Round Rock, TX
Practice pattern: Clinical Cardiology — Primarily office-based clinical cardiology
301 SETON PKWY STE 103, Round Rock, TX 78665
5123244815
Registered in NPPES since 2007
NPI: 1861699506 verify on NPPES ↗
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating. This page presents federal public records about Dr. Upadhyaya from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Upadhyaya

Dr. Prashant Upadhyaya is a surgery specialist in Round Rock, TX, with 19 years of NPI registration. Based on federal Medicare data, Dr. Upadhyaya performed 12 Medicare services in 2023. These records do not provide a deduplicated patient total.

Between the years covered by Open Payments, Dr. Upadhyaya received a total of $2,856 from 9 pharmaceutical and/or device companies across 14 payment records. A record can group multiple payments. These transfers are publicly reported through CMS Open Payments. Disclosure alone does not establish their effect on care. A reliable breakdown by payment category is not available in this snapshot. Patients may wish to discuss these relationships with their provider.

The Data Coverage level for Dr. Upadhyaya is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.

✓ 19 years of NPI registration ▲ 12 Medicare services $2,856 industry payments

Medicare Practice Summary — 2023

Medicare Utilization ↗
12
Medicare services
Bottom 1% in TX for surgery
Lower Medicare volume may reflect subspecialty focus, hospital-based work, or a higher share of non-Medicare patients.
Not available
Unique patients (not deduplicated)
$119
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →

Top procedures by volume

Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.

Procedure Volume Avg. paid Avg. submitted
New patient office visit (45-59 min)
An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter.
12 $119 $484
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. These counts do not measure clinical quality or years of experience.

Industry Payment Transparency

Open Payments through 2024 ↗
$2,856
Total received (2018-2024)
Avg $571/year across 5 years
Top 49% in TX for surgery
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
9
Companies
14
Payment records
Payments are publicly reported; disclosure does not establish legality · Not evidence of wrongdoing · How to interpret →

Payment categories are unavailable while the source breakdown is being rebuilt. Company and year totals do not identify how much belongs to each category.

Payment trend by year

Annual totals from pharmaceutical and medical device companies.

2024
$270
2023
$124
2022
$150
2019
$2,202
2018
$109

Payments by company (2024)

TELA Bio, Inc.
$162
Mentor Worldwide LLC
$74
BIOCOMPOSITES INC
$19
Integra LifeSciences Corporation
$15
Top 3 companies account for 94.4% of 2024 payments
All-time payments by company (2018-2024) ›
KCI USA, Inc
$2,090
Mentor Worldwide LLC
$186
TELA Bio, Inc.
$162
Allergan, Inc.
$150
Allergan Inc.
$109
KCI USA, Inc.
$81
AbbVie Inc.
$43
BIOCOMPOSITES INC
$19
Integra LifeSciences Corporation
$15
Top 3 companies account for 85.4% of all-time payments
Associated products mentioned in payments ›
ALLODERM · Integra · MENTOR CPX 2 Breast Tissue Expander · MENTOR MemoryGel Resterilizable Gel Sizer · MemoryGel Breast Implants · NATRELLE SALINE-FILLED BREAST IMPLANTS · OviTex 2S · PREVENA · STIMULAN · VAC VERAFLO
Should you be concerned? Industry payments are disclosed through CMS Open Payments. Disclosure alone does not establish their purpose, legality, or effect on care. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Looking for a surgery specialist in Round Rock?
Compare surgerists in the Round Rock area by procedure volume, costs, and industry payment transparency.
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Geographic Context

Surgerists in nearby ZIP areas
176
County median income
$108,309
Nearest hospital to ZIP centroid (approximate)
BAYLOR SCOTT & WHITE MEDICAL CENTER - ROUND ROCK
3.1 mi

Data Sources

Provider Registry NPPES NPPES snapshot; verify current record
Medicare Enrollment PECOS PECOS snapshot
Practice Data Medicare Util. Annual (CY lag)
Industry Payments Open Payments CY 2024
Disciplinary History — Not included N/A

This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →

Summary

Dr. Upadhyaya is a clinical cardiology specialist, with moderate Medicare volume, with 19 years of NPI registration.

This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →

Frequently Asked Questions

Is Dr. Upadhyaya experienced with new patient office visit (45-59 min)?
Based on Medicare claims data, Dr. Upadhyaya performed 12 new patient office visit (45-59 min) services. These records cover Medicare fee-for-service activity, including eligible younger beneficiaries; they do not measure total practice volume or clinical quality.
Does Dr. Upadhyaya receive payments from pharmaceutical companies?
Yes. Dr. Upadhyaya received a total of $2,856 from 9 companies across 14 payment records. A record can group multiple payments. These transfers are publicly disclosed through CMS Open Payments. Disclosure alone does not establish their legality or effect on care. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Upadhyaya's costs compare to other surgerists in Round Rock?
Dr. Upadhyaya's average Medicare payment per service is $119. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Upadhyaya) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating the presence of registry, enrollment, activity or payment records, not verified experience or clinical quality. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Source publication dates and the snapshots loaded on this site can differ. Rebuilding a page does not refresh its source records. Check the Medicare reporting year and the payment interval shown above; consult the linked official sources for newer releases and current registry details. See our data freshness policy →
About this page

This page combines public CMS records with calculated summaries and explanatory procedure labels. These transformations are not verbatim federal records. Sources: NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.

This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.

Provider corrections: Provider portal · Privacy questions: Privacy Policy · Terms: Terms of Use · Methodology: Methodology

Data Disclaimer — Data sourced from the Centers for Medicare & Medicaid Services (CMS): National Plan and Provider Enumeration System (NPPES), Open Payments program, Medicare Provider Utilization and Payment Data, and Provider Enrollment & Certification data (PECOS). Published under the Freedom of Information Act (FOIA). This website is not affiliated with, endorsed by, or authorized by CMS, HHS, or the U.S. Government. Data may contain errors as reported to CMS by providers and reporting entities. Industry payment disclosure alone establishes neither wrongdoing nor legality. Medicare data reflects only patients aged 65+ or those with qualifying disabilities. For corrections, contact CMS directly. This information does not constitute medical advice and should not be used as the sole basis for choosing a healthcare provider. Procedure descriptions use plain language and do not reference CPT® codes, which are copyrighted by the American Medical Association. Full methodology → · Report a data error → · Privacy policy →