This provider's $7.0M 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 | $1.4K | $263.54 | 5.29x | $1.1K | $614.7K | 6.8K | 4.8K |
| 2015 | $951.83 | $187.27 | 5.08x | $764.56 | $535.4K | 6.4K | 4.6K |
| 2016 | $1.0K | $205.83 | 5.08x | $838.99 | $645.5K | 6.3K | 4.5K |
| 2017 | $765.09 | $197.38 | 3.88x | $567.71 | $827.0K | 7.6K | 5.3K |
| 2018 | $945.91 | $191.35 | 4.94x | $754.56 | $733.0K | 7.6K | 5.4K |
| 2019 | $1.2K | $221.66 | 5.40x | $975.22 | $704.6K | 6.9K | 5.3K |
| 2020 | $1.2K | $234.39 | 5.11x | $963.97 | $629.0K | 5.3K | 4.0K |
| 2021 | $1.1K | $206.06 | 5.31x | $889.04 | $733.9K | 6.3K | 5.0K |
| 2022 | $1.2K | $207.17 | 5.92x | $1.0K | $771.8K | 7.4K | 5.6K |
| 2023 | $878.20 | $128.07 | 6.86x | $750.13 | $811.4K | 11.5K | 6.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.2K | $1.4M | $1.2K | 5.39x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.1K | $1.3M | $1.2K | 5.28x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 13.8K | $826.9K | $59.75 | 4.37x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 7.5K | $408.3K | $54.38 | 4.97x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 451 | $391.9K | $868.98 | 5.20x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.2K | $290.3K | $91.94 | 4.48x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.1K | $265.7K | $127.61 | 4.29x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 2.0K | $239.0K | $120.08 | 2.96x |
| 27446 | Repair of knee joint | 198 | $211.6K | $1.1K | 4.09x |
| 73564 | X-ray of knee, 4 or more views | 5.8K | $205.4K | $35.31 | 4.41x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.4K | $196.8K | $82.17 | 4.88x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 5.2K | $178.8K | $34.47 | 4.82x |
| 73562 | X-ray of knee, 3 views | 5.4K | $161.8K | $29.69 | 4.58x |
| 64624 | Destruction of genicular nerve branches of knee by injection using imaging guidance | 403 | $130.4K | $323.68 | 5.34x |
| 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 | 2.3K | $100.3K | $44.45 | 4.27x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 545 | $74.5K | $136.71 | 2.60x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.0K | $70.3K | $35.74 | 4.50x |
| 77073 | Imaging for bone length assessment | 1.3K | $48.5K | $36.05 | 4.60x |
| 73721 | MRI scan of leg joint | 328 | $42.9K | $130.74 | 7.58x |
| 64640 | Destruction of peripheral nerve or branch | 396 | $41.4K | $104.45 | 9.89x |
This provider submits charges 4.94 times higher than what Medicare actually pays.
A markup ratio of 4.94x means for every $100 Medicare pays, this provider initially charges $494. 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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