Providers
RUPA RAVINDRA SHETTY, M.D.
NPI 1962428235, individual, Myrtle Beach, SC, Psychiatry & Neurology, Psychiatry
5
Evidence tier
informational
- Medicaid dollars per patient on code 99232 ($188 per patient-month) sit in the top 5% of every provider billing that code.
score 35 of 100, rank 10106, $1.0M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RUPA RAVINDRA SHETTY, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | July 13, 2006, last updated June 2, 2016 |
| Practice location | 237 AVENUE OF THE PALMS, Myrtle Beach, SC 29579-1247, 843-461-6133 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 27604 SC) Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, license 27604 SC) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $789K | 49% | $188 | $67 (top 5% from $174) | 96th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $253K | 16% | $149 | $81 (top 5% from $170) | 92nd percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $235K | 15% | $130 | $96 (top 5% from $249) | 70th percentile | |
| 99239 | Hospital discharge day management, more than 30 minutes | $220K | 14% | $80 | $49 (top 5% from $101) | 85th percentile | |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | $119K | 7% | $103 | $63 (top 5% from $137) | 84th percentile |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 338 | 72 | $20K | $125 | $74 | 1.7x | 2.6x (90th percentile 4.3x) |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 107 | 60 | $9K | $175 | $111 | 1.6x | 2.6x (90th percentile 4.7x) |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 60 | 55 | $8K | $275 | $162 | 1.7x | 3.0x (90th percentile 5.6x) |
| 99239 | Hospital discharge day management, more than 30 minutes | 55 | 54 | $5K | $200 | $107 | 1.9x | 2.8x (90th percentile 5.6x) |
| 90791 | Psychiatric diagnostic evaluation | 19 | 16 | $2K | $215 | $154 | 1.4x | 1.9x (90th percentile 3.6x) |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 83 | 57 | $1K | $115 | $21 | 5.4x | 2.5x (90th percentile 4.6x) |
| 96372 | Injection of drug or substance under skin or into muscle | 83 | 38 | $551 | $25 | $13 | 1.9x | 3.6x (90th percentile 6.4x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
4 providers in Horry County, SC carry an indicator in the public record, with $2.8M at stake between them. The most common is more hours than a day holds, on 3 of them, followed by part of a provider network on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | LORIS REHAB AND NURSING CENTER, LLC Loris, SC, ranked 1763 | $0 |
|
| 5 | MELISSA SWARTZ Murrells Inlet, SC, ranked 10556 | $1.4M |
|
| 5 | ADEDAPO ODUWOLE Myrtle Beach, SC, ranked 10974 | $1.2M | |
| 5 | SUSAN HAMMOND Conway, SC, ranked 11428 | $234K |
Recent enforcement in SC
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedMar 11, 2026
Former Greenville CEO, Employees Indicted in Multi-Million Dollar Health Care Fraud Scheme
The defendants submitted false claims to health care benefit programs for individual COVID-19 tests that had actually been pooled for combined processing and manipulated test processing software, billing for tests that were virtually worthless and ineligible for reimbursement.
DOJSentencedFeb 25, 2026
Lancaster Trio Sentenced for Health Care Fraud Conspiracy
An excluded Medicaid provider and his wife established Transformation Services in her name to bill Medicaid for behavioral health services that were overlapping, not rendered individually, and provided by unlicensed therapists, defrauding Medicaid of nearly $250,000.
DOJIndictedNov 18, 2025
Florida Man Indicted for Health Care Fraud, Wire Fraud in Durable Medical Equipment Scheme
Weinberger, who was excluded from Medicare, allegedly concealed his ownership and control of a Medicare-enrolled durable medical equipment company through a false enrollment document and, with coconspirators, used call centers to generate doctors' orders for orthotic braces and submit approximately $6.7 million in false and fraudulent claims obtained through kickbacks and bribes, medically unnecessary, or otherwise ineligible for reimbursement.
DOJCivil judgmentJul 17, 2025
United States and the States of Georgia, Colorado, and South Carolina Obtain $114.5M in Judgments in a Sprawling Cancer Genetic Testing Lab Scheme
Premier Medical, its owner and compliance vice president paid kickbacks to Freedom Medical Labs and its marketers, who collected DNA samples from Medicaid beneficiaries in public spaces and purchased telemedicine physician orders, to bill Medicaid for medically unnecessary cancer genetic testing.
DOJIndictedJun 30, 2025
S.C. Cases Among Hundreds Announced in National Health Care Fraud Takedown
Two defendants were charged with submitting false claims to Medicare and Medicaid for durable medical equipment that was not delivered or authorized, and with billing the Veterans Administration for massage therapy services not rendered.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.