This provider's $5.9M in total Medicare payments ranks in the 99th percentile of Sports Medicine 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 | $153.98 | $53.78 | 2.86x | $100.20 | $494.9K | 7.2K | 3.3K |
| 2015 | $149.41 | $50.67 | 2.95x | $98.74 | $541.0K | 7.9K | 3.3K |
| 2016 | $166.26 | $53.96 | 3.08x | $112.30 | $595.8K | 8.9K | 3.8K |
| 2017 | $171.25 | $55.12 | 3.11x | $116.13 | $545.6K | 10.3K | 4.3K |
| 2018 | $170.12 | $51.63 | 3.29x | $118.49 | $660.5K | 10.8K | 4.9K |
| 2019 | $223.63 | $89.18 | 2.51x | $134.45 | $850.3K | 10.8K | 4.8K |
| 2020 | $248.77 | $81.21 | 3.06x | $167.56 | $481.8K | 7.8K | 3.6K |
| 2021 | $225.38 | $76.89 | 2.93x | $148.49 | $603.0K | 8.7K | 4.1K |
| 2022 | $346.09 | $75.68 | 4.57x | $270.41 | $623.1K | 8.9K | 4.2K |
| 2023 | $427.18 | $71.19 | 6.00x | $355.99 | $489.1K | 8.5K | 4.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 14.6K | $1.9M | $129.21 | 2.81x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 28.3K | $1.8M | $62.88 | 5.59x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 15.6K | $939.6K | $60.04 | 2.79x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.1K | $256.6K | $82.11 | 2.86x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.5K | $247.9K | $99.09 | 4.94x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 1.6K | $179.0K | $110.51 | 3.16x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $135.4K | $128.85 | 4.99x |
| 73564 | X-ray of knee, 4 or more views | 3.3K | $118.6K | $36.41 | 3.64x |
| 20551 | Injections of tendon attachment to bone | 2.0K | $85.0K | $42.61 | 4.93x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 124 | $80.2K | $646.74 | 2.55x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.3K | $33.3K | $26.59 | 4.11x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 639 | $23.2K | $36.35 | 3.63x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 318 | $21.2K | $66.56 | 3.38x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 257 | $13.9K | $54.05 | 7.04x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 33 | $13.3K | $403.67 | 5.75x |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 11.3K | $13.1K | $1.16 | 2.90x |
| J7329 | Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg | 1.0K | $7.2K | $7.04 | 4.07x |
| 73562 | X-ray of knee, 3 views | 216 | $7.0K | $32.44 | 2.91x |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 1.1K | $6.3K | $5.53 | 2.17x |
| 29125 | Application of non-moveable, short arm splint (forearm to hand) | 107 | $5.0K | $46.29 | 6.05x |
This provider submits charges 3.88 times higher than what Medicare actually pays.
A markup ratio of 3.88x means for every $100 Medicare pays, this provider initially charges $388. 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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