This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Cardiac Surgery providers nationally.
Their average markup ratio of 8.16x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 127% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 152% in 2015
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 | $6.0K | $791.76 | 7.55x | $5.2K | $156.5K | 212 | 212 |
| 2015 | $6.0K | $864.03 | 6.95x | $5.1K | $394.1K | 665 | 665 |
| 2016 | $6.9K | $923.03 | 7.44x | $5.9K | $404.3K | 707 | 707 |
| 2017 | $5.8K | $778.36 | 7.42x | $5.0K | $438.4K | 774 | 774 |
| 2018 | $4.0K | $524.11 | 7.65x | $3.5K | $330.1K | 620 | 620 |
| 2019 | $6.4K | $785.90 | 8.14x | $5.6K | $398.2K | 699 | 699 |
| 2020 | $3.5K | $419.95 | 8.37x | $3.1K | $315.3K | 702 | 698 |
| 2021 | $3.3K | $433.65 | 7.63x | $2.9K | $394.1K | 947 | 933 |
| 2022 | $4.4K | $573.13 | 7.67x | $3.8K | $400.3K | 876 | 872 |
| 2023 | $6.3K | $745.90 | 8.44x | $5.5K | $355.3K | 745 | 739 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 33361 | Replacement of aortic valve with prosthetic valve, accessed through the skin | 2.3K | $1.8M | $786.18 | 9.51x |
| 33405 | Replacement of left lower heart chamber valve using artificial valve on heart-lung machine | 280 | $532.0K | $1.9K | 7.33x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 2.3K | $450.5K | $192.12 | 4.31x |
| 33533 | Heart artery bypass to repair one artery | 161 | $209.3K | $1.3K | 8.92x |
| 33430 | Replacement of valve between left upper and lower chambers on heart-lung machine | 83 | $201.3K | $2.4K | 6.93x |
| 33025 | Creation of opening or partial removal of sac that covers the heart | 179 | $69.9K | $390.73 | 13.00x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 434 | $64.7K | $149.05 | 4.70x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 216 | $31.6K | $146.20 | 4.54x |
| 33534 | Heart artery bypass to repair multiple arteries | 14 | $28.6K | $2.0K | 6.07x |
| 0483T | Insertion of artificial valve between left heart chambers, accessed through the skin | 26 | $22.5K | $864.93 | 8.43x |
| 33365 | Replacement of aortic valve with prosthetic valve | 20 | $21.4K | $1.1K | 10.29x |
| 33418 | Repair of mitral valve through the skin, initial prosthesis | 18 | $19.8K | $1.1K | 10.45x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 107 | $18.1K | $169.45 | 4.99x |
| 33464 | Repair of heart valve between right chambers with insertion of prosthetic valve ring | 11 | $17.6K | $1.6K | 8.49x |
| 33518 | Combined multiple vein and artery heart artery bypasses | 44 | $17.0K | $386.46 | 5.45x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 108 | $10.6K | $98.61 | 5.13x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 66 | $8.2K | $124.73 | 4.57x |
| 33257 | Destruction and reconstruction of right upper heart | 14 | $7.8K | $555.71 | 5.34x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 57 | $5.6K | $98.20 | 5.31x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 60 | $5.5K | $91.92 | 4.49x |
This provider submits charges 8.16 times higher than what Medicare actually pays.
A markup ratio of 8.16x means for every $100 Medicare pays, this provider initially charges $816. 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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