This provider's $4.7M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 322% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 64% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $441.46 | $261.45 | 1.69x | $180.01 | $153.1K | 1.7K | 1.2K |
| 2015 | $403.75 | $246.93 | 1.64x | $156.82 | $207.8K | 2.5K | 1.7K |
| 2016 | $469.85 | $287.31 | 1.64x | $182.54 | $246.9K | 2.6K | 1.8K |
| 2017 | $441.98 | $311.69 | 1.42x | $130.29 | $388.7K | 4.6K | 2.5K |
| 2018 | $367.20 | $244.31 | 1.50x | $122.89 | $444.3K | 5.9K | 3.1K |
| 2019 | $476.37 | $289.38 | 1.65x | $186.99 | $610.1K | 5.6K | 3.1K |
| 2020 | $489.88 | $269.35 | 1.82x | $220.53 | $438.7K | 4.3K | 2.9K |
| 2021 | $1.2K | $244.12 | 5.04x | $987.42 | $720.5K | 4.9K | 3.7K |
| 2022 | $1.4K | $233.22 | 5.89x | $1.1K | $856.5K | 5.9K | 4.4K |
| 2023 | $1.3K | $208.43 | 6.32x | $1.1K | $645.9K | 5.5K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 1.4K | $1.0M | $751.61 | 1.78x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.5K | $595.5K | $62.39 | 1.68x |
| 27447 | Repair of knee joint | 504 | $580.9K | $1.2K | 4.37x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 8.6K | $517.6K | $60.34 | 2.90x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 2.7K | $435.4K | $158.62 | 1.60x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 507 | $321.7K | $634.57 | 2.32x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 253 | $285.7K | $1.1K | 4.38x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.0K | $207.4K | $102.03 | 2.61x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.0K | $161.5K | $82.50 | 1.70x |
| 73562 | X-ray of knee, 3 views | 2.5K | $93.7K | $37.34 | 3.00x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 664 | $88.6K | $133.38 | 3.04x |
| 73564 | X-ray of knee, 4 or more views | 1.5K | $51.4K | $34.65 | 1.99x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 1.6K | $51.4K | $32.46 | 2.83x |
| 73560 | X-ray of knee, 1 or 2 views | 2.8K | $49.2K | $17.45 | 2.28x |
| 27245 | Surgical treatment of broken thigh bone | 39 | $40.6K | $1.0K | 1.47x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 260 | $37.4K | $143.93 | 2.54x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.1K | $29.2K | $27.53 | 2.77x |
| 27125 | Partial replacement of thigh bone at hip joint with prosthesis | 24 | $24.0K | $999.22 | 1.69x |
| 72170 | X-ray of pelvis, 1 or 2 views | 961 | $19.1K | $19.90 | 3.07x |
| J0702 | Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg | 3.5K | $16.5K | $4.74 | 1.77x |
This provider submits charges 2.52 times higher than what Medicare actually pays.
A markup ratio of 2.52x means for every $100 Medicare pays, this provider initially charges $252. 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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