This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Cardiac Surgery 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 | $616.34 | $418.66 | 1.47x | $197.68 | $506.2K | 2.2K | 2.1K |
| 2015 | $444.78 | $294.44 | 1.51x | $150.34 | $431.6K | 2.2K | 2.2K |
| 2016 | $475.68 | $304.78 | 1.56x | $170.90 | $529.9K | 3.0K | 2.6K |
| 2017 | $477.71 | $302.76 | 1.58x | $174.95 | $533.1K | 3.3K | 2.9K |
| 2018 | $383.10 | $246.01 | 1.56x | $137.09 | $514.1K | 3.6K | 3.1K |
| 2019 | $481.19 | $327.19 | 1.47x | $154.00 | $648.2K | 3.7K | 3.2K |
| 2020 | $488.28 | $327.32 | 1.49x | $160.96 | $565.1K | 3.1K | 2.7K |
| 2021 | $329.21 | $224.81 | 1.46x | $104.40 | $376.7K | 2.5K | 2.2K |
| 2022 | $422.43 | $270.57 | 1.56x | $151.86 | $418.2K | 2.4K | 2.2K |
| 2023 | $1.1K | $246.12 | 4.32x | $817.35 | $375.4K | 1.9K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 33533 | Heart artery bypass to repair one artery | 547 | $697.7K | $1.3K | 1.61x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 2.4K | $345.1K | $145.65 | 1.45x |
| 37215 | Insertion of stents and blood clot protection device in neck artery, accessed through the skin | 425 | $310.5K | $730.59 | 1.63x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 2.2K | $283.6K | $129.89 | 1.57x |
| 33361 | Replacement of aortic valve with prosthetic valve, accessed through the skin | 483 | $278.6K | $576.83 | 2.23x |
| 33405 | Replacement of left lower heart chamber valve using artificial valve on heart-lung machine | 181 | $246.3K | $1.4K | 1.57x |
| 33430 | Replacement of valve between left upper and lower chambers on heart-lung machine | 103 | $206.1K | $2.0K | 1.31x |
| 35301 | Removal of blood clot and portion of artery of neck | 231 | $188.7K | $817.08 | 1.35x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 940 | $139.9K | $148.83 | 1.32x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $130.5K | $114.07 | 1.53x |
| 33259 | Destruction of tissue and reconstruction of right upper heart on heart-lung machine | 173 | $107.2K | $619.71 | 1.30x |
| 34705 | Placement of graft for repair of aorta and groin arteries including radiological supervision and interpretation | 92 | $101.6K | $1.1K | 1.36x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.8K | $97.7K | $54.73 | 1.55x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 3.0K | $88.9K | $29.51 | 1.54x |
| 33208 | Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes | 224 | $85.1K | $379.80 | 1.49x |
| 33511 | Heart artery bypass to repair multiple arteries | 64 | $78.2K | $1.2K | 1.65x |
| 33518 | Combined multiple vein and artery heart artery bypasses | 227 | $67.3K | $296.56 | 1.49x |
| 33512 | Heart artery bypass to repair multiple arteries | 39 | $66.0K | $1.7K | 1.35x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 586 | $59.1K | $100.87 | 1.30x |
| 33362 | Replacement of aortic valve with prosthetic valve, open procedure | 91 | $58.9K | $646.73 | 2.17x |
This provider submits charges 1.66 times higher than what Medicare actually pays.
A markup ratio of 1.66x means for every $100 Medicare pays, this provider initially charges $166. This is lower 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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