This provider's $4.0M 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 | $428.70 | $77.88 | 5.50x | $350.82 | $449.5K | 6.1K | 3.6K |
| 2015 | $423.82 | $82.25 | 5.15x | $341.57 | $415.3K | 5.5K | 3.1K |
| 2016 | $441.42 | $83.50 | 5.29x | $357.92 | $354.3K | 4.7K | 2.9K |
| 2017 | $348.24 | $82.53 | 4.22x | $265.71 | $320.1K | 4.4K | 2.7K |
| 2018 | $355.99 | $78.67 | 4.53x | $277.32 | $305.0K | 4.3K | 2.7K |
| 2019 | $535.22 | $115.43 | 4.64x | $419.79 | $429.7K | 5.3K | 3.1K |
| 2020 | $329.02 | $81.27 | 4.05x | $247.75 | $405.4K | 5.4K | 3.4K |
| 2021 | $563.82 | $125.28 | 4.50x | $438.54 | $461.9K | 5.2K | 3.3K |
| 2022 | $356.21 | $81.23 | 4.39x | $274.98 | $435.8K | 5.3K | 3.3K |
| 2023 | $422.54 | $80.83 | 5.23x | $341.71 | $390.4K | 4.5K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 13.4K | $1.1M | $84.90 | 1.77x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.5K | $664.2K | $88.81 | 1.43x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 5.2K | $455.8K | $88.06 | 3.58x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 3.9K | $423.3K | $109.91 | 3.22x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 935 | $233.0K | $249.24 | 3.74x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.2K | $185.8K | $58.35 | 1.85x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 786 | $140.5K | $178.70 | 4.21x |
| 36475 | Destruction of insufficient vein of arm or leg, accessed through the skin | 75 | $83.8K | $1.1K | 4.60x |
| 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 354 | $76.4K | $215.93 | 13.90x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 563 | $67.9K | $120.66 | 2.64x |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 561 | $62.9K | $112.12 | 3.86x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 817 | $50.6K | $61.97 | 1.71x |
| 93970 | Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers | 240 | $37.5K | $156.29 | 2.93x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 619 | $32.2K | $52.05 | 2.85x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 2.5K | $31.4K | $12.71 | 3.00x |
| 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 3.1K | $21.0K | $6.85 | 3.79x |
| 96374 | Injection of drug or substance into a vein for therapy, diagnosis, or prevention | 547 | $20.9K | $38.20 | 4.14x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 324 | $20.2K | $62.21 | 4.74x |
| 93296 | Remote evaluations of single, dual, or multiple lead pacemaker or cardioverter-defibrillator transmissions, technician review, support, and distribution of results up to 90 days | 1.0K | $19.6K | $19.35 | 4.26x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 121 | $19.2K | $159.02 | 5.00x |
This provider submits charges 2.87 times higher than what Medicare actually pays.
A markup ratio of 2.87x means for every $100 Medicare pays, this provider initially charges $287. 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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