This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 6.44x 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 | $1.3K | $134.56 | 9.85x | $1.2K | $416.9K | 5.8K | 3.3K |
| 2015 | $1.7K | $163.94 | 10.27x | $1.5K | $473.0K | 5.8K | 4.0K |
| 2016 | $1.1K | $128.19 | 8.91x | $1.0K | $400.5K | 5.5K | 3.6K |
| 2017 | $1.3K | $142.17 | 8.98x | $1.1K | $402.1K | 5.2K | 3.4K |
| 2018 | $2.5K | $165.87 | 15.28x | $2.4K | $377.7K | 5.1K | 3.4K |
| 2019 | $1.8K | $149.52 | 12.01x | $1.6K | $362.4K | 4.7K | 3.1K |
| 2020 | $770.94 | $133.64 | 5.77x | $637.30 | $346.9K | 4.4K | 2.9K |
| 2021 | $766.56 | $128.74 | 5.95x | $637.82 | $420.9K | 5.3K | 3.5K |
| 2022 | $577.24 | $144.65 | 3.99x | $432.59 | $438.2K | 5.4K | 3.4K |
| 2023 | $692.65 | $178.58 | 3.88x | $514.07 | $434.8K | 5.1K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 7.5K | $690.3K | $92.19 | 5.55x |
| 27447 | Repair of knee joint | 529 | $617.0K | $1.2K | 9.29x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.6K | $455.1K | $60.27 | 3.67x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.1K | $363.7K | $89.77 | 3.49x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 255 | $297.8K | $1.2K | 10.03x |
| 73564 | X-ray of knee, 4 or more views | 5.6K | $241.8K | $43.38 | 4.27x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 713 | $126.1K | $176.91 | 4.17x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 1.7K | $120.0K | $69.63 | 5.30x |
| 29880 | Removal of both knee cartilages using an endoscope | 319 | $118.9K | $372.87 | 15.89x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 1.9K | $98.1K | $50.56 | 9.06x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 806 | $96.8K | $120.05 | 3.66x |
| 73721 | MRI scan of leg joint | 657 | $91.9K | $139.95 | 8.75x |
| 93970 | Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers | 540 | $74.4K | $137.82 | 4.49x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 813 | $64.8K | $79.65 | 4.57x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 1.9K | $64.0K | $34.48 | 5.85x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 478 | $61.7K | $129.07 | 5.65x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 966 | $56.3K | $58.23 | 8.23x |
| 73221 | MRI scan of arm joint | 377 | $52.2K | $138.52 | 8.96x |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 4.7K | $40.9K | $8.78 | 2.20x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.4K | $39.4K | $27.89 | 5.42x |
This provider submits charges 6.44 times higher than what Medicare actually pays.
A markup ratio of 6.44x means for every $100 Medicare pays, this provider initially charges $644. 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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