This provider's $3.4M in total Medicare payments ranks in the 98th percentile of Cardiac Surgery providers nationally.
Medicare payments to this provider grew 173% from 2014 to 2023.
89% of their billing comes from a single procedure code (99291 — Critical care delivery critically ill or injured patient, first 30-74 minutes).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 174% 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 | $862.59 | $283.21 | 3.05x | $579.38 | $144.6K | 798 | 190 |
| 2015 | $267.22 | $97.13 | 2.75x | $170.09 | $396.4K | 2.4K | 310 |
| 2016 | $1.1K | $344.89 | 3.16x | $743.48 | $378.7K | 2.2K | 241 |
| 2017 | $1.0K | $284.85 | 3.69x | $765.06 | $519.2K | 3.0K | 248 |
| 2018 | $283.00 | $95.03 | 2.98x | $187.97 | $280.9K | 1.7K | 192 |
| 2019 | $1.2K | $287.52 | 4.25x | $935.50 | $398.9K | 2.3K | 280 |
| 2020 | $283.00 | $96.78 | 2.92x | $186.22 | $353.6K | 2.0K | 196 |
| 2021 | $238.75 | $96.48 | 2.47x | $142.27 | $254.0K | 1.5K | 145 |
| 2022 | $238.75 | $95.40 | 2.50x | $143.35 | $271.3K | 1.6K | 151 |
| 2023 | $248.33 | $96.55 | 2.57x | $151.78 | $394.4K | 2.3K | 153 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 16.2K | $3.0M | $185.73 | 2.96x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.9K | $174.7K | $91.33 | 1.75x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.3K | $112.6K | $88.51 | 2.49x |
| 33533 | Heart artery bypass to repair one artery | 50 | $68.7K | $1.4K | 3.71x |
| 36800 | Insertion of external tube from vein to vein for dialysis | 93 | $9.7K | $104.32 | 4.41x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 48 | $8.3K | $173.95 | 2.18x |
| 32124 | Opening in chest with release of lung lining | 14 | $5.5K | $395.16 | 5.57x |
| 99292 | Critical care delivery critically ill or injured patient | 24 | $2.2K | $92.08 | 3.04x |
| 76937 | Ultrasound guidance for accessing into blood vessel | 169 | $2.1K | $12.17 | 2.88x |
| 93314 | Interpretation and report of heart ultrasound examination using esophageal probe | 26 | $1.7K | $66.22 | 2.72x |
| 36620 | Insertion of arterial catheter for blood sampling or infusion, accessed through the skin | 11 | $473.83 | $43.08 | 3.48x |
| 33508 | Harvest of veins for coronary artery bypass procedure using an endoscope | 24 | $282.23 | $11.76 | 3.86x |
This provider submits charges 2.9 times higher than what Medicare actually pays.
A markup ratio of 2.9x means for every $100 Medicare pays, this provider initially charges $290. 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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