This provider's $5.9M 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 | $454.68 | $133.59 | 3.40x | $321.09 | $752.0K | 9.8K | 5.7K |
| 2015 | $452.49 | $133.39 | 3.39x | $319.10 | $727.0K | 8.7K | 5.1K |
| 2016 | $505.71 | $136.75 | 3.70x | $368.96 | $688.1K | 8.6K | 5.2K |
| 2017 | $469.15 | $130.05 | 3.61x | $339.10 | $622.2K | 8.0K | 5.1K |
| 2018 | $459.17 | $115.52 | 3.97x | $343.65 | $551.9K | 8.3K | 5.1K |
| 2019 | $515.46 | $126.11 | 4.09x | $389.35 | $634.6K | 7.6K | 4.6K |
| 2020 | $475.80 | $111.25 | 4.28x | $364.55 | $415.7K | 5.8K | 3.5K |
| 2021 | $442.36 | $111.17 | 3.98x | $331.19 | $481.2K | 6.7K | 3.9K |
| 2022 | $484.74 | $115.16 | 4.21x | $369.58 | $547.0K | 7.3K | 4.1K |
| 2023 | $401.62 | $104.12 | 3.86x | $297.50 | $508.2K | 7.6K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 18.5K | $1.3M | $68.99 | 2.17x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 12.0K | $919.8K | $76.64 | 2.94x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 5.1K | $662.8K | $129.41 | 3.74x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 453 | $431.9K | $953.37 | 2.49x |
| 73721 | MRI scan of leg joint | 1.6K | $353.1K | $220.68 | 5.80x |
| 73221 | MRI scan of arm joint | 1.2K | $273.9K | $222.87 | 5.74x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.7K | $245.2K | $91.61 | 2.48x |
| 29881 | Removal of one knee cartilage using an endoscope | 407 | $171.0K | $420.06 | 3.33x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.8K | $133.4K | $47.78 | 3.70x |
| 29880 | Removal of both knee cartilages using an endoscope | 259 | $129.1K | $498.46 | 3.01x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 1.7K | $115.8K | $70.07 | 5.71x |
| 72148 | MRI scan of lower spinal canal | 507 | $104.2K | $205.49 | 5.84x |
| 29826 | Shaving of shoulder bone using an endoscope | 665 | $101.0K | $151.91 | 9.15x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 848 | $83.6K | $98.63 | 2.26x |
| 29823 | Extensive removal of shoulder joint tissue using an endoscope | 196 | $76.2K | $388.66 | 3.54x |
| 73562 | X-ray of knee, 3 views | 2.0K | $70.4K | $36.03 | 2.55x |
| 20552 | Injections of trigger points in 1 or 2 muscles | 1.5K | $70.0K | $47.55 | 2.53x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 9.1K | $69.7K | $7.68 | 2.61x |
| 29822 | Removal of shoulder joint tissue using an endoscope | 279 | $61.0K | $218.69 | 7.30x |
| 73030 | X-ray of shoulder, minimum of 2 views | 2.0K | $58.1K | $29.76 | 2.69x |
This provider submits charges 3.4 times higher than what Medicare actually pays.
A markup ratio of 3.4x means for every $100 Medicare pays, this provider initially charges $340. 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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