This provider's $5.2M in total Medicare payments ranks in the 99th percentile of Orthopedic 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 | $755.61 | $181.71 | 4.16x | $573.90 | $686.5K | 11.4K | 8.6K |
| 2015 | $698.32 | $166.01 | 4.21x | $532.31 | $642.5K | 11.7K | 8.8K |
| 2016 | $742.16 | $177.49 | 4.18x | $564.67 | $667.1K | 11.7K | 8.8K |
| 2017 | $698.26 | $162.59 | 4.29x | $535.67 | $586.8K | 10.8K | 7.8K |
| 2018 | $667.81 | $159.34 | 4.19x | $508.47 | $503.8K | 10.2K | 7.3K |
| 2019 | $775.22 | $175.83 | 4.41x | $599.39 | $463.4K | 8.0K | 5.7K |
| 2020 | $918.49 | $175.27 | 5.24x | $743.22 | $367.4K | 6.5K | 4.8K |
| 2021 | $896.25 | $178.81 | 5.01x | $717.44 | $434.3K | 7.3K | 5.3K |
| 2022 | $930.43 | $184.67 | 5.04x | $745.76 | $412.1K | 7.0K | 5.0K |
| 2023 | $925.53 | $180.62 | 5.12x | $744.91 | $403.0K | 6.7K | 4.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 17.8K | $988.4K | $55.40 | 2.98x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.2K | $488.1K | $79.06 | 2.39x |
| 23472 | Prosthetic repair of shoulder joint | 415 | $389.7K | $938.96 | 5.16x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 4.5K | $337.1K | $74.43 | 2.98x |
| 25447 | Removal of bone joints between wrist and fingers | 306 | $200.2K | $654.09 | 3.09x |
| 64721 | Release and/or relocation of median nerve of hand | 630 | $195.7K | $310.58 | 4.23x |
| 23412 | Repair of torn tendons of shoulder, open procedure | 290 | $192.1K | $662.56 | 4.50x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 3.8K | $178.2K | $46.67 | 3.38x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 5.9K | $171.0K | $29.10 | 4.25x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 454 | $166.9K | $367.64 | 6.54x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $157.9K | $116.29 | 2.88x |
| 26123 | Removal of tissue of palm | 222 | $149.5K | $673.44 | 3.07x |
| 73030 | X-ray of shoulder, minimum of 2 views | 5.7K | $126.7K | $22.23 | 4.28x |
| 29848 | Release of wrist ligament using an endoscope | 342 | $115.9K | $338.94 | 4.30x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 2.3K | $115.5K | $50.35 | 5.23x |
| 73120 | X-ray of hand, 2 views | 5.4K | $108.0K | $20.10 | 3.87x |
| 20600 | Aspiration and/or injection of small joint or joint capsule | 3.9K | $98.2K | $25.33 | 4.91x |
| 23430 | Anchoring of biceps tendon | 340 | $96.6K | $284.06 | 7.85x |
| 26480 | Transplant of tendon of hand | 292 | $87.8K | $300.80 | 6.03x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 1.2K | $82.2K | $68.35 | 4.02x |
This provider submits charges 3.93 times higher than what Medicare actually pays.
A markup ratio of 3.93x means for every $100 Medicare pays, this provider initially charges $393. 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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