This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Cardiac Surgery providers nationally.
Medicare payments to this provider grew 63% from 2014 to 2023.
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 | $237.81 | $114.75 | 2.07x | $123.06 | $278.4K | 3.5K | 2.2K |
| 2015 | $199.58 | $96.85 | 2.06x | $102.73 | $327.7K | 4.5K | 2.8K |
| 2016 | $203.90 | $101.26 | 2.01x | $102.64 | $253.1K | 3.4K | 2.3K |
| 2017 | $334.78 | $135.19 | 2.48x | $199.59 | $367.7K | 3.6K | 3.0K |
| 2018 | $522.39 | $134.06 | 3.90x | $388.33 | $449.0K | 4.4K | 3.8K |
| 2019 | $479.83 | $133.67 | 3.59x | $346.16 | $419.9K | 4.8K | 4.0K |
| 2020 | $484.02 | $135.56 | 3.57x | $348.46 | $431.0K | 4.7K | 3.9K |
| 2021 | $546.98 | $141.42 | 3.87x | $405.56 | $446.4K | 5.0K | 4.3K |
| 2022 | $558.64 | $155.57 | 3.59x | $403.07 | $435.1K | 5.1K | 4.1K |
| 2023 | $642.39 | $168.79 | 3.81x | $473.60 | $453.5K | 5.2K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 1.3K | $463.5K | $350.36 | 3.20x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 6.9K | $394.9K | $57.46 | 2.52x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.2K | $363.1K | $112.93 | 2.98x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.6K | $350.3K | $62.51 | 2.68x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.2K | $255.3K | $79.42 | 2.41x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 855 | $216.9K | $253.67 | 3.05x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.4K | $213.9K | $157.37 | 2.40x |
| 92928 | Catheter insertion of stents in major coronary artery or branch, accessed through the skin | 372 | $177.2K | $476.27 | 2.80x |
| 33361 | Replacement of aortic valve with prosthetic valve, accessed through the skin | 248 | $166.0K | $669.24 | 5.65x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $132.4K | $123.71 | 3.09x |
| 99220 | Hospital observation care typically 70 minutes per day | 790 | $119.3K | $151.03 | 2.84x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.1K | $118.2K | $109.65 | 3.12x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 1.3K | $114.8K | $91.14 | 2.57x |
| 93460 | Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart | 230 | $87.1K | $378.76 | 3.17x |
| 92941 | Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel during heart attack, accessed through the skin | 126 | $73.9K | $586.60 | 2.62x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 1.4K | $71.0K | $49.54 | 3.46x |
| 93312 | Insertion of probe in esophagus for heart ultrasound examination including interpretation and report | 631 | $55.1K | $87.37 | 2.98x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 4.2K | $50.2K | $11.86 | 3.24x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 602 | $49.8K | $82.70 | 2.75x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour ekg up to 30 days | 64 | $38.2K | $596.44 | 2.94x |
This provider submits charges 3 times higher than what Medicare actually pays.
A markup ratio of 3x means for every $100 Medicare pays, this provider initially charges $300. 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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