This provider's $3.2M in total Medicare payments ranks in the 97th percentile of Cardiology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $615.65 | $384.89 | 1.60x | $230.76 | $405.8K | 1.7K | 1.5K |
| 2015 | $651.10 | $303.04 | 2.15x | $348.06 | $340.6K | 1.6K | 1.4K |
| 2016 | $1.2K | $292.43 | 4.07x | $899.07 | $372.6K | 1.5K | 1.4K |
| 2017 | $1.1K | $288.47 | 3.81x | $809.58 | $364.0K | 1.5K | 1.4K |
| 2018 | $1.2K | $348.64 | 3.43x | $846.89 | $324.1K | 1.3K | 1.3K |
| 2019 | $1.2K | $379.44 | 3.27x | $861.81 | $374.2K | 1.3K | 1.3K |
| 2020 | $1.4K | $452.18 | 3.19x | $988.27 | $326.3K | 1.0K | 979 |
| 2021 | $1.4K | $409.70 | 3.31x | $945.89 | $241.7K | 742 | 716 |
| 2022 | $1.7K | $490.78 | 3.53x | $1.2K | $258.3K | 731 | 724 |
| 2023 | $1.3K | $382.48 | 3.49x | $951.83 | $236.4K | 810 | 788 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 33533 | Heart artery bypass to repair one artery | 868 | $1.1M | $1.3K | 3.63x |
| 33405 | Replacement of left lower heart chamber valve using artificial valve on heart-lung machine | 136 | $200.1K | $1.5K | 2.75x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.3K | $193.5K | $147.85 | 2.32x |
| 33361 | Replacement of aortic valve with prosthetic valve, accessed through the skin | 258 | $146.7K | $568.76 | 3.81x |
| 35301 | Removal of blood clot and portion of artery of neck | 177 | $136.8K | $773.00 | 3.45x |
| 33519 | Combined multiple vein and artery heart artery bypasses | 289 | $115.4K | $399.23 | 2.67x |
| 33430 | Replacement of valve between left upper and lower chambers on heart-lung machine | 54 | $110.4K | $2.0K | 2.03x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 924 | $107.6K | $116.43 | 2.31x |
| 34705 | Placement of graft for repair of aorta and groin arteries including radiological supervision and interpretation | 83 | $93.7K | $1.1K | 1.40x |
| 33208 | Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes | 237 | $90.0K | $379.76 | 5.62x |
| 33518 | Combined multiple vein and artery heart artery bypasses | 289 | $87.7K | $303.45 | 2.63x |
| 32480 | Removal of one lobe of lung | 74 | $79.9K | $1.1K | 2.95x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 488 | $73.3K | $150.22 | 1.95x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $67.7K | $53.85 | 2.27x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 552 | $55.6K | $100.75 | 2.19x |
| 33521 | Combined multiple vein and artery heart artery bypasses | 103 | $49.6K | $481.29 | 2.88x |
| 33362 | Replacement of aortic valve with prosthetic valve, open procedure | 68 | $46.4K | $682.02 | 3.24x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 434 | $33.1K | $76.17 | 2.31x |
| 33025 | Creation of opening or partial removal of sac that covers the heart | 51 | $28.7K | $562.11 | 2.90x |
| 33530 | Reoperation of heart artery bypass or valve procedure more than 1 month after original operation | 73 | $28.5K | $390.31 | 2.25x |
This provider submits charges 3.17 times higher than what Medicare actually pays.
A markup ratio of 3.17x means for every $100 Medicare pays, this provider initially charges $317. 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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