This provider's $4.7M in total Medicare payments ranks in the 99th percentile of Thoracic Surgery providers nationally.
Their average markup ratio of 6.77x is significantly above the specialty median of 4.7x.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 78% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $3.4K | $543.84 | 6.19x | $2.8K | $640.6K | 1.3K | 1.2K |
| 2015 | $4.0K | $611.87 | 6.48x | $3.4K | $601.7K | 1.3K | 1.2K |
| 2016 | $3.5K | $557.71 | 6.25x | $2.9K | $585.0K | 1.2K | 1.2K |
| 2017 | $3.1K | $490.37 | 6.42x | $2.7K | $527.0K | 1.2K | 1.2K |
| 2018 | $4.0K | $627.23 | 6.43x | $3.4K | $491.1K | 1.1K | 1.1K |
| 2019 | $4.5K | $678.88 | 6.61x | $3.8K | $470.6K | 1.1K | 1.1K |
| 2020 | $4.6K | $649.14 | 7.05x | $3.9K | $220.5K | 510 | 508 |
| 2021 | $4.8K | $717.91 | 6.71x | $4.1K | $392.1K | 852 | 848 |
| 2022 | $6.0K | $860.93 | 6.94x | $5.1K | $329.4K | 732 | 728 |
| 2023 | $4.7K | $670.06 | 7.00x | $4.0K | $392.8K | 833 | 829 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 33405 | Replacement of left lower heart chamber valve using artificial valve on heart-lung machine | 719 | $1.3M | $1.8K | 6.19x |
| 33533 | Heart artery bypass to repair one artery | 626 | $792.6K | $1.3K | 8.64x |
| 33361 | Replacement of aortic valve with prosthetic valve, accessed through the skin | 1.1K | $764.4K | $699.96 | 9.38x |
| 33430 | Replacement of valve between left upper and lower chambers on heart-lung machine | 207 | $488.3K | $2.4K | 5.35x |
| 33427 | Repair of valve flaps between left heart chambers on heart-lung machine | 158 | $325.3K | $2.1K | 5.88x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.1K | $289.1K | $140.32 | 3.04x |
| 33257 | Destruction and reconstruction of right upper heart | 207 | $103.1K | $498.16 | 6.47x |
| 33518 | Combined multiple vein and artery heart artery bypasses | 235 | $81.2K | $345.50 | 5.88x |
| 33860 | Placement of graft to aorta on heart-lung machine | 24 | $66.9K | $2.8K | 5.97x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 498 | $57.6K | $115.76 | 5.25x |
| 33510 | Heart artery bypass to repair one artery | 59 | $49.1K | $832.48 | 11.66x |
| 33530 | Reoperation of heart artery bypass or valve procedure more than 1 month after original operation | 104 | $46.7K | $448.97 | 5.87x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.1K | $43.9K | $40.39 | 2.94x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 565 | $36.1K | $63.89 | 3.05x |
| 33519 | Combined multiple vein and artery heart artery bypasses | 74 | $33.1K | $447.10 | 6.01x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 359 | $32.7K | $91.10 | 3.24x |
| 33517 | Combined vein and artery heart artery bypass | 176 | $27.9K | $158.41 | 6.25x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 754 | $25.0K | $33.18 | 5.05x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 326 | $19.6K | $60.07 | 3.93x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 413 | $19.5K | $47.34 | 3.99x |
This provider submits charges 6.77 times higher than what Medicare actually pays.
A markup ratio of 6.77x means for every $100 Medicare pays, this provider initially charges $677. 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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