This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Thoracic Surgery providers nationally.
Their average markup ratio of 9.82x is significantly above the specialty median of 4.7x.
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 | $4.7K | $655.37 | 7.16x | $4.0K | $481.0K | 791 | 789 |
| 2015 | $7.0K | $838.76 | 8.34x | $6.2K | $345.1K | 663 | 618 |
| 2016 | $4.7K | $537.76 | 8.75x | $4.2K | $348.7K | 1.0K | 969 |
| 2017 | $6.6K | $780.61 | 8.49x | $5.8K | $434.4K | 966 | 945 |
| 2018 | $7.9K | $941.75 | 8.40x | $7.0K | $492.1K | 885 | 882 |
| 2019 | $8.6K | $998.37 | 8.57x | $7.6K | $579.0K | 1.0K | 1.0K |
| 2020 | $7.7K | $656.98 | 11.65x | $7.0K | $366.8K | 713 | 713 |
| 2021 | $7.3K | $627.44 | 11.62x | $6.7K | $388.6K | 811 | 807 |
| 2022 | $10.8K | $987.83 | 10.94x | $9.8K | $488.2K | 905 | 900 |
| 2023 | $8.2K | $674.46 | 12.18x | $7.5K | $403.1K | 898 | 895 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 33361 | Replacement of aortic valve with prosthetic valve, accessed through the skin | 2.4K | $1.9M | $784.41 | 12.32x |
| 33418 | Replacement of aortic valve with prosthetic valve accessed through the skin | 505 | $801.2K | $1.6K | 8.06x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.3K | $492.1K | $148.98 | 5.62x |
| 33405 | Replacement of left lower heart chamber valve using artificial valve on heart-lung machine | 251 | $473.6K | $1.9K | 9.40x |
| 33430 | Replacement of valve between left upper and lower chambers on heart-lung machine | 86 | $226.9K | $2.6K | 8.15x |
| 92986 | Catheter based repair of left lower heart (aortic) valve, accessed through the skin | 112 | $135.0K | $1.2K | 5.75x |
| 33419 | Replacement of aortic valve with prosthetic valve accessed through the skin | 233 | $89.5K | $384.16 | 15.49x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 326 | $32.6K | $100.14 | 4.91x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 398 | $27.4K | $68.82 | 4.64x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 142 | $25.5K | $179.70 | 2.50x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 245 | $24.0K | $98.01 | 5.52x |
| 93456 | Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts | 78 | $23.5K | $301.04 | 16.58x |
| 33426 | Insertion of artificial valve between left heart chambers on heart-lung machine | 13 | $22.4K | $1.7K | 11.91x |
| 33464 | Repair of heart valve between right chambers with insertion of prosthetic valve ring | 11 | $22.1K | $2.0K | 10.47x |
| 33496 | Repair of artificial heart valve on heart-lung machine | 11 | $17.1K | $1.6K | 9.29x |
| 33533 | Heart artery bypass to repair one artery | 16 | $14.1K | $880.57 | 13.22x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 355 | $13.8K | $38.99 | 3.83x |
| 33530 | Reoperation of heart artery bypass or valve procedure more than 1 month after original operation | 25 | $11.9K | $475.57 | 4.96x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 91 | $11.4K | $124.83 | 4.97x |
| 92928 | Catheter insertion of stents in major coronary artery or branch, accessed through the skin | 17 | $7.0K | $411.53 | 10.04x |
This provider submits charges 9.82 times higher than what Medicare actually pays.
A markup ratio of 9.82x means for every $100 Medicare pays, this provider initially charges $982. 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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