Remuneration can influence worker`s motivation, and improve their performance. Likewise in hospital as capital-intensive, human resources-intensive as well as knowledge and technology-intensive health care institution. This study aimed to analyze employee's perception of remuneration system implementation and adult cardiac surgery services unit's performance at hospital. This study used a mixed method approach (quantitative and qualitative). Quantitative study design was cross-sectional using questionnaire for self-assesment. Meanwhile, qualitative study design was descriptive conducted through focus group discussion and document review on data in forms of schedule book, registration book, nursing notes and medical records. Data collection was conducted in 2013 at one hospital in Jakarta. Respondents/informants were functional medical staff, nurses, and administration staff amounted to 29 people. Data was analyzed using univariate and content analysis techniques. Results showed most functional medical staff dan nurse were unsatisfied (71.2%) with several things in remuneration system implementation, such as in payroll system and grading determination. However, adult cardiac surgery services unit's performance is increasing every year before and after the implementation of remuneration system. This hospital is expected to improve the remuneration system in accordance with policy and arrange incentive formulation that is more appropriate with current condition as well as followed with proper socialization and periodical evaluation.