This provider's $3.3M in total Medicare payments ranks in the 99th percentile of Thoracic Surgery providers nationally.
Their average markup ratio of 7.53x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 53% from 2014 to 2023.
78% of their billing comes from a single procedure code (33361 — Replacement of aortic valve with prosthetic valve, accessed through the skin).
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $1.2K | $195.59 | 6.14x | $1.0K | $249.2K | 641 | 639 |
| 2015 | $1.2K | $191.49 | 6.39x | $1.0K | $299.2K | 786 | 779 |
| 2016 | $1.7K | $253.52 | 6.83x | $1.5K | $377.2K | 1.0K | 1.0K |
| 2017 | $2.2K | $301.22 | 7.35x | $1.9K | $348.3K | 1.0K | 1.0K |
| 2018 | $2.3K | $311.27 | 7.39x | $2.0K | $321.4K | 1.0K | 1.0K |
| 2019 | $1.7K | $244.55 | 6.90x | $1.4K | $365.5K | 1.1K | 1.1K |
| 2020 | $1.2K | $172.46 | 6.92x | $1.0K | $249.7K | 857 | 856 |
| 2021 | $2.4K | $323.42 | 7.55x | $2.1K | $294.8K | 974 | 972 |
| 2022 | $1.6K | $272.97 | 5.99x | $1.4K | $390.1K | 1.2K | 1.2K |
| 2023 | $2.8K | $471.08 | 5.91x | $2.3K | $381.6K | 1.1K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 33361 | Replacement of aortic valve with prosthetic valve, accessed through the skin | 3.7K | $2.5M | $682.57 | 8.39x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.8K | $426.9K | $111.39 | 3.85x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 1.1K | $94.2K | $81.99 | 3.97x |
| 33418 | Replacement of aortic valve with prosthetic valve accessed through the skin | 93 | $78.9K | $848.82 | 8.64x |
| 0646T | Implantation of artificial valve between right upper and lower chambers of heart through catheter | 30 | $31.3K | $1.0K | 1.77x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 264 | $17.3K | $65.48 | 3.93x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 138 | $15.4K | $111.57 | 3.85x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 210 | $15.0K | $71.22 | 3.74x |
| 33999 | Other heart surgery procedure | 22 | $14.9K | $676.77 | 8.87x |
| 0483T | Insertion of artificial valve between left heart chambers, accessed through the skin | 22 | $14.9K | $675.42 | 8.13x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 84 | $7.7K | $92.22 | 3.91x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 31 | $5.2K | $167.60 | 3.92x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 45 | $4.0K | $89.29 | 3.74x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 13 | $1.9K | $143.26 | 3.82x |
| 99232 | Follow-up hospital inpatient care per day, typically 25 minutes | 14 | $847.59 | $60.54 | 3.79x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 11 | $480.04 | $43.64 | 3.76x |
This provider submits charges 7.53 times higher than what Medicare actually pays.
A markup ratio of 7.53x means for every $100 Medicare pays, this provider initially charges $753. This is higher than the national average.
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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