This provider's $8.0M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 7.14x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 152% from 2014 to 2023.
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 | $1.7K | $217.78 | 7.59x | $1.4K | $469.3K | 4.7K | 3.9K |
| 2015 | $1.7K | $223.67 | 7.57x | $1.5K | $638.7K | 6.0K | 5.1K |
| 2016 | $1.7K | $224.96 | 7.62x | $1.5K | $733.1K | 5.7K | 5.2K |
| 2017 | $1.9K | $238.51 | 8.06x | $1.7K | $699.0K | 4.4K | 4.2K |
| 2018 | $2.7K | $363.34 | 7.47x | $2.4K | $731.6K | 2.8K | 2.6K |
| 2019 | $1.7K | $242.58 | 7.21x | $1.5K | $801.9K | 3.0K | 2.9K |
| 2020 | $2.7K | $362.26 | 7.34x | $2.3K | $844.8K | 2.6K | 2.5K |
| 2021 | $2.5K | $332.27 | 7.53x | $2.2K | $920.3K | 3.0K | 2.9K |
| 2022 | $2.7K | $361.81 | 7.50x | $2.4K | $1.0M | 3.1K | 3.0K |
| 2023 | $1.9K | $263.88 | 7.26x | $1.7K | $1.2M | 3.8K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 3.4K | $4.0M | $1.2K | 7.75x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.5K | $1.8M | $1.2K | 7.65x |
| 27446 | Repair of knee joint | 430 | $440.6K | $1.0K | 8.78x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.0K | $350.9K | $69.67 | 3.16x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 4.7K | $339.1K | $72.09 | 4.44x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 172 | $260.1K | $1.5K | 7.94x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 5.0K | $245.6K | $49.07 | 3.06x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.9K | $186.3K | $48.39 | 3.72x |
| 27486 | Revision of one component of total knee joint prosthesis | 95 | $118.0K | $1.2K | 8.14x |
| 27442 | Repair of knee joint | 87 | $63.8K | $733.11 | 6.98x |
| 73562 | X-ray of knee, 3 views | 4.2K | $47.1K | $11.28 | 3.81x |
| 27438 | Repair of knee cap with insertion of prosthesis | 87 | $34.5K | $396.98 | 8.25x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 765 | $32.6K | $42.64 | 7.86x |
| 73564 | X-ray of knee, 4 or more views | 2.5K | $30.1K | $11.86 | 4.21x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 12 | $19.8K | $1.6K | 7.29x |
| 77073 | Imaging for bone length assessment | 1.2K | $14.1K | $11.74 | 5.13x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.3K | $13.4K | $10.06 | 4.46x |
| 73560 | X-ray of knee, 1 or 2 views | 1.2K | $10.2K | $8.33 | 3.65x |
| 73500 | X-ray of hip on one side of body, 1 view | 946 | $10.1K | $10.69 | 4.47x |
| 73501 | X-ray of hip with pelvis, 1 view | 1.3K | $9.7K | $7.44 | 4.17x |
This provider submits charges 7.14 times higher than what Medicare actually pays.
A markup ratio of 7.14x means for every $100 Medicare pays, this provider initially charges $714. 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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