This provider's $6.5M 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 | $2.4K | $377.85 | 6.35x | $2.0K | $622.2K | 6.3K | 4.2K |
| 2015 | $1.9K | $301.71 | 6.30x | $1.6K | $570.9K | 6.0K | 4.0K |
| 2016 | $2.1K | $322.45 | 6.56x | $1.8K | $641.0K | 6.5K | 4.3K |
| 2017 | $2.0K | $347.93 | 5.82x | $1.7K | $724.7K | 6.9K | 4.3K |
| 2018 | $2.1K | $364.88 | 5.78x | $1.7K | $719.4K | 7.2K | 4.5K |
| 2019 | $2.0K | $382.44 | 5.25x | $1.6K | $722.5K | 6.8K | 4.3K |
| 2020 | $1.9K | $347.20 | 5.59x | $1.6K | $483.6K | 5.4K | 3.6K |
| 2021 | $1.9K | $353.71 | 5.24x | $1.5K | $707.8K | 6.3K | 4.1K |
| 2022 | $2.1K | $355.66 | 5.94x | $1.8K | $700.8K | 5.7K | 3.9K |
| 2023 | $1.1K | $236.06 | 4.53x | $832.59 | $566.1K | 5.1K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.2K | $1.3M | $1.1K | 5.93x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.7K | $814.7K | $83.67 | 2.68x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 618 | $672.5K | $1.1K | 5.66x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 1.2K | $640.0K | $540.05 | 1.85x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 10.0K | $466.1K | $46.39 | 3.86x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 316 | $444.7K | $1.4K | 5.56x |
| 23472 | Prosthetic repair of shoulder joint | 274 | $321.2K | $1.2K | 5.48x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 198 | $305.7K | $1.5K | 5.50x |
| 73562 | X-ray of knee, 3 views | 8.9K | $252.1K | $28.47 | 3.95x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $176.8K | $119.03 | 2.94x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 4.5K | $148.0K | $32.83 | 2.74x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.6K | $116.1K | $74.88 | 2.70x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 102 | $110.1K | $1.1K | 1.39x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 127 | $109.5K | $862.55 | 5.41x |
| 73564 | X-ray of knee, 4 or more views | 3.1K | $98.3K | $31.79 | 4.14x |
| 73030 | X-ray of shoulder, minimum of 2 views | 3.3K | $78.8K | $24.03 | 3.89x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 406 | $49.7K | $122.45 | 2.65x |
| J0702 | Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg | 8.6K | $42.9K | $4.97 | 2.16x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 690 | $38.9K | $56.38 | 2.71x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 160 | $34.7K | $217.18 | 13.01x |
This provider submits charges 4.45 times higher than what Medicare actually pays.
A markup ratio of 4.45x means for every $100 Medicare pays, this provider initially charges $445. 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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