This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.46x is significantly above the specialty median of 4.7x.
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 | $1.1K | $207.36 | 5.52x | $936.36 | $344.7K | 2.7K | 2.3K |
| 2015 | $1.4K | $255.44 | 5.52x | $1.2K | $291.8K | 2.0K | 1.7K |
| 2016 | $1.6K | $251.94 | 6.36x | $1.3K | $370.4K | 2.3K | 2.1K |
| 2017 | $1.4K | $202.81 | 6.79x | $1.2K | $364.1K | 2.5K | 2.3K |
| 2018 | $1.9K | $285.47 | 6.63x | $1.6K | $387.9K | 2.3K | 2.0K |
| 2019 | $1.7K | $291.75 | 5.93x | $1.4K | $473.6K | 2.4K | 2.2K |
| 2020 | $1.9K | $301.38 | 6.39x | $1.6K | $490.7K | 2.4K | 2.2K |
| 2021 | $1.8K | $311.05 | 5.83x | $1.5K | $678.9K | 3.0K | 2.8K |
| 2022 | $1.7K | $311.84 | 5.51x | $1.4K | $546.6K | 2.3K | 2.1K |
| 2023 | $1.6K | $299.89 | 5.39x | $1.3K | $498.2K | 2.1K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 753 | $1.1M | $1.5K | 3.56x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.7K | $418.1K | $89.17 | 3.53x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 597 | $359.8K | $602.64 | 5.31x |
| 22634 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 566 | $220.7K | $389.88 | 3.54x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 137 | $183.4K | $1.3K | 3.60x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 373 | $169.9K | $455.46 | 15.45x |
| 63056 | Release of lower spinal cord and/or nerves | 283 | $169.4K | $598.56 | 8.44x |
| 22214 | Incision of spinal column (single column osteotomy) in 1 vertebral segment of upper back (lumbar spine) to correct deformity | 237 | $145.4K | $613.49 | 8.80x |
| 72148 | MRI scan of lower spinal canal | 1.3K | $140.0K | $110.46 | 10.60x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 624 | $126.1K | $202.15 | 3.77x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.9K | $103.3K | $54.97 | 3.12x |
| 63003 | Partial removal of bone and/or release of middle spinal cord or spinal nerves | 104 | $101.4K | $975.02 | 6.40x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 685 | $85.3K | $124.51 | 3.39x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 138 | $83.2K | $603.18 | 3.79x |
| 63057 | Release of middle or lower spinal cord and/or nerves | 265 | $66.7K | $251.78 | 3.83x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 396 | $66.3K | $167.38 | 8.36x |
| 22216 | Incision of spinal column (single column osteotomy) in additional vertebral segment of spine | 216 | $61.9K | $286.38 | 4.17x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 184 | $59.3K | $322.30 | 5.90x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 56 | $53.1K | $948.16 | 5.70x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 1.3K | $52.6K | $39.84 | 3.57x |
This provider submits charges 5.46 times higher than what Medicare actually pays.
A markup ratio of 5.46x means for every $100 Medicare pays, this provider initially charges $546. 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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