This provider's $3.8M in total Medicare payments ranks in the 99th percentile of Hand 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 | $205.72 | $96.67 | 2.13x | $109.05 | $429.0K | 8.4K | 6.4K |
| 2015 | $190.37 | $93.35 | 2.04x | $97.02 | $424.6K | 8.8K | 6.3K |
| 2016 | $246.48 | $116.09 | 2.12x | $130.39 | $390.3K | 8.1K | 5.9K |
| 2017 | $190.61 | $88.47 | 2.15x | $102.14 | $319.7K | 7.1K | 5.3K |
| 2018 | $528.67 | $112.20 | 4.71x | $416.47 | $371.6K | 6.9K | 5.3K |
| 2019 | $621.24 | $109.91 | 5.65x | $511.33 | $405.7K | 7.2K | 5.6K |
| 2020 | $470.79 | $82.42 | 5.71x | $388.37 | $307.9K | 6.7K | 4.6K |
| 2021 | $479.34 | $80.49 | 5.96x | $398.85 | $356.7K | 7.1K | 5.2K |
| 2022 | $357.92 | $60.23 | 5.94x | $297.69 | $360.7K | 7.6K | 5.6K |
| 2023 | $432.07 | $74.87 | 5.77x | $357.20 | $415.1K | 8.7K | 6.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 15.0K | $903.5K | $60.41 | 3.50x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 5.5K | $445.7K | $81.08 | 3.79x |
| 29848 | Release of wrist ligament using an endoscope | 951 | $374.7K | $394.00 | 4.29x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 7.1K | $281.1K | $39.45 | 4.60x |
| 73130 | X-ray of hand, minimum of 3 views | 8.3K | $217.8K | $26.26 | 3.91x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.4K | $211.3K | $88.06 | 4.48x |
| 20526 | Injection of carpal tunnel | 2.1K | $147.9K | $71.67 | 3.85x |
| 26145 | Repair of tendon, finger and/or hand | 455 | $139.0K | $305.45 | 5.24x |
| 20600 | Aspiration and/or injection of small joint or joint capsule | 3.4K | $117.7K | $34.90 | 4.89x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 777 | $96.4K | $124.09 | 3.10x |
| 11960 | Insertion of tissue expanders | 110 | $93.9K | $853.49 | 4.50x |
| 20605 | Aspiration and/or injection of medium joint or joint capsule | 2.2K | $85.4K | $39.06 | 4.18x |
| 73110 | X-ray of wrist, minimum of 3 views | 2.5K | $72.1K | $29.02 | 3.63x |
| 95905 | Needle measurement and recording of movement and/or feeling of arm or leg with interpretation and report | 1.1K | $53.4K | $50.00 | 3.37x |
| 25609 | Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments | 55 | $46.9K | $852.79 | 2.36x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 10.6K | $41.9K | $3.96 | 3.28x |
| 25600 | Closed treatment of broken forearm bones | 139 | $38.2K | $274.57 | 2.07x |
| 72040 | X-ray of spine of neck, 2 or 3 views | 927 | $26.6K | $28.65 | 3.86x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1.3K | $26.2K | $20.42 | 4.21x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 1.3K | $23.4K | $17.70 | 4.57x |
This provider submits charges 3.93 times higher than what Medicare actually pays.
A markup ratio of 3.93x means for every $100 Medicare pays, this provider initially charges $393. 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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