This provider's $6.9M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 6.33x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 78% from 2014 to 2023.
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 | $1.3K | $159.22 | 8.34x | $1.2K | $482.2K | 5.1K | 3.8K |
| 2015 | $1.4K | $166.09 | 8.50x | $1.2K | $484.3K | 5.6K | 4.1K |
| 2016 | $1.2K | $166.67 | 7.28x | $1.0K | $409.8K | 4.8K | 3.4K |
| 2017 | $1.3K | $211.48 | 6.25x | $1.1K | $515.7K | 5.1K | 3.6K |
| 2018 | $2.2K | $318.86 | 6.82x | $1.9K | $639.9K | 5.7K | 3.9K |
| 2019 | $2.4K | $409.30 | 5.98x | $2.0K | $910.1K | 6.5K | 4.8K |
| 2020 | $1.2K | $212.50 | 5.76x | $1.0K | $726.5K | 5.3K | 4.3K |
| 2021 | $1.2K | $230.26 | 5.35x | $1.0K | $930.4K | 5.9K | 4.9K |
| 2022 | $1.2K | $224.41 | 5.43x | $994.98 | $925.1K | 6.3K | 5.3K |
| 2023 | $1.2K | $183.27 | 6.60x | $1.0K | $858.7K | 6.8K | 5.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.7K | $1.8M | $1.1K | 6.72x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 901 | $971.4K | $1.1K | 7.25x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 1.1K | $711.8K | $647.70 | 2.70x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.2K | $605.9K | $84.19 | 7.01x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 8.6K | $456.7K | $53.35 | 8.06x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.3K | $446.9K | $53.81 | 7.18x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 438 | $320.2K | $731.04 | 2.98x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 2.0K | $272.1K | $134.76 | 6.82x |
| 73562 | X-ray of knee, 3 views | 6.1K | $149.3K | $24.45 | 6.03x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.0K | $146.6K | $74.78 | 7.38x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 1.0K | $128.1K | $124.16 | 4.78x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 808 | $95.2K | $117.86 | 7.14x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.6K | $91.6K | $34.85 | 7.18x |
| 99205 | New patient outpatient visit, total time 60-74 minutes | 567 | $89.5K | $157.92 | 7.12x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.8K | $82.1K | $28.94 | 5.60x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 674 | $77.8K | $115.43 | 5.47x |
| 64624 | Destruction of nerve branches of knee using imaging guidance | 228 | $72.7K | $318.81 | 6.37x |
| 64640 | Destruction of peripheral nerve or branch | 405 | $47.4K | $116.97 | 11.11x |
| 27245 | Surgical treatment of broken thigh bone | 48 | $47.1K | $981.03 | 6.66x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 26 | $38.7K | $1.5K | 6.86x |
This provider submits charges 6.33 times higher than what Medicare actually pays.
A markup ratio of 6.33x means for every $100 Medicare pays, this provider initially charges $633. 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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