This provider's $3.6M 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 | $674.35 | $185.63 | 3.63x | $488.72 | $331.0K | 5.1K | 3.2K |
| 2015 | $559.63 | $159.23 | 3.51x | $400.40 | $326.7K | 5.0K | 3.3K |
| 2016 | $593.04 | $161.25 | 3.68x | $431.79 | $351.5K | 5.4K | 3.5K |
| 2017 | $531.67 | $141.52 | 3.76x | $390.15 | $356.0K | 5.9K | 3.7K |
| 2018 | $573.48 | $156.94 | 3.65x | $416.54 | $372.6K | 5.7K | 3.7K |
| 2019 | $619.23 | $174.74 | 3.54x | $444.49 | $402.5K | 5.8K | 3.8K |
| 2020 | $398.50 | $109.18 | 3.65x | $289.32 | $300.5K | 4.6K | 3.2K |
| 2021 | $629.12 | $178.70 | 3.52x | $450.42 | $404.7K | 4.9K | 3.5K |
| 2022 | $306.78 | $73.13 | 4.19x | $233.65 | $361.3K | 5.3K | 3.6K |
| 2023 | $547.57 | $148.34 | 3.69x | $399.23 | $417.4K | 5.6K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12.1K | $796.6K | $65.76 | 3.33x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 11.1K | $683.1K | $61.77 | 5.78x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 3.4K | $377.2K | $111.04 | 3.79x |
| 27447 | Repair of knee joint | 247 | $330.0K | $1.3K | 3.37x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.3K | $295.2K | $90.41 | 3.64x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.8K | $193.5K | $107.84 | 3.07x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 135 | $174.1K | $1.3K | 3.38x |
| 73562 | X-ray of knee, 3 views | 3.0K | $104.0K | $34.64 | 3.37x |
| 29880 | Removal of both knee cartilages using an endoscope | 228 | $103.4K | $453.69 | 4.57x |
| 27245 | Surgical treatment of broken thigh bone | 75 | $89.2K | $1.2K | 3.28x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.6K | $46.9K | $28.62 | 4.72x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 347 | $41.3K | $119.14 | 3.40x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.3K | $32.8K | $26.12 | 3.97x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 673 | $32.0K | $47.52 | 1.79x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 808 | $31.3K | $38.69 | 3.37x |
| 20600 | Aspiration and/or injection of small joint or joint capsule | 694 | $28.6K | $41.18 | 4.49x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 566 | $20.8K | $36.77 | 5.98x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 123 | $17.1K | $138.74 | 3.68x |
| 20605 | Aspiration and/or injection of medium joint or joint capsule | 395 | $16.8K | $42.62 | 4.61x |
| 73565 | X-ray of both knees, standing, front to back view | 470 | $16.8K | $35.79 | 3.16x |
This provider submits charges 3.98 times higher than what Medicare actually pays.
A markup ratio of 3.98x means for every $100 Medicare pays, this provider initially charges $398. 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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