This provider's $8.7M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 7.02x 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 | $2.5K | $191.90 | 12.91x | $2.3K | $853.4K | 12.5K | 6.7K |
| 2015 | $1.4K | $113.93 | 11.93x | $1.2K | $810.2K | 13.3K | 7.5K |
| 2016 | $1.7K | $152.80 | 11.20x | $1.6K | $934.4K | 14.0K | 8.0K |
| 2017 | $1.5K | $124.94 | 12.04x | $1.4K | $782.2K | 12.7K | 7.5K |
| 2018 | $2.3K | $165.92 | 14.10x | $2.2K | $867.6K | 12.5K | 7.4K |
| 2019 | $2.8K | $218.27 | 12.62x | $2.5K | $846.3K | 9.0K | 6.6K |
| 2020 | $2.2K | $199.34 | 11.14x | $2.0K | $759.7K | 10.5K | 6.5K |
| 2021 | $1.7K | $139.54 | 12.53x | $1.6K | $937.0K | 12.1K | 7.5K |
| 2022 | $1.5K | $128.23 | 12.02x | $1.4K | $1.0M | 13.0K | 8.0K |
| 2023 | $1.7K | $143.99 | 11.79x | $1.6K | $915.0K | 12.0K | 7.9K |
| 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 | 20.7K | $1.8M | $86.66 | 5.49x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 20.5K | $1.2M | $60.67 | 2.19x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 9.0K | $1.2M | $127.88 | 3.99x |
| 27447 | Repair of knee joint | 951 | $1.1M | $1.2K | 10.77x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 654 | $775.5K | $1.2K | 20.55x |
| 73560 | X-ray of knee, 1 or 2 views | 9.0K | $272.5K | $30.33 | 4.68x |
| 73565 | X-ray of both knees, standing, front to back view | 8.8K | $270.5K | $30.67 | 3.53x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.0K | $264.2K | $87.41 | 1.97x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.5K | $209.5K | $82.63 | 2.58x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 3.5K | $188.4K | $54.55 | 7.37x |
| 72170 | X-ray of pelvis, 1 or 2 views | 5.4K | $128.2K | $23.89 | 6.83x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 896 | $118.3K | $132.00 | 3.80x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 5.4K | $115.8K | $21.44 | 4.25x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 1.9K | $111.8K | $60.45 | 13.50x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 65 | $103.3K | $1.6K | 9.65x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 719 | $90.8K | $126.35 | 2.39x |
| 72148 | MRI scan of lower spinal canal | 668 | $82.6K | $123.68 | 19.65x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.3K | $82.0K | $36.40 | 3.84x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 45 | $76.8K | $1.7K | 18.57x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 1.9K | $74.3K | $39.90 | 5.48x |
This provider submits charges 7.02 times higher than what Medicare actually pays.
A markup ratio of 7.02x means for every $100 Medicare pays, this provider initially charges $702. 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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