This provider's $4.6M 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 | $681.62 | $133.27 | 5.11x | $548.35 | $454.6K | 7.3K | 5.0K |
| 2015 | $289.05 | $83.39 | 3.47x | $205.66 | $442.7K | 7.6K | 5.2K |
| 2016 | $365.55 | $109.90 | 3.33x | $255.65 | $474.7K | 8.0K | 5.6K |
| 2017 | $342.06 | $100.90 | 3.39x | $241.16 | $496.9K | 8.8K | 6.2K |
| 2018 | $397.18 | $111.72 | 3.56x | $285.46 | $485.7K | 8.6K | 6.0K |
| 2019 | $309.38 | $97.88 | 3.16x | $211.50 | $458.9K | 7.7K | 5.4K |
| 2020 | $365.57 | $108.12 | 3.38x | $257.45 | $376.9K | 6.6K | 4.8K |
| 2021 | $189.73 | $66.87 | 2.84x | $122.86 | $453.4K | 7.4K | 5.2K |
| 2022 | $364.60 | $105.12 | 3.47x | $259.48 | $479.8K | 7.6K | 5.5K |
| 2023 | $326.64 | $94.10 | 3.47x | $232.54 | $468.1K | 7.7K | 5.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 22.0K | $1.4M | $65.12 | 2.55x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 8.4K | $750.1K | $88.82 | 3.15x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 5.1K | $428.1K | $83.93 | 2.66x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 4.6K | $195.8K | $42.17 | 3.15x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 1.5K | $189.9K | $125.68 | 2.91x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 2.6K | $140.9K | $53.93 | 5.49x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.4K | $136.8K | $95.66 | 2.56x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 151 | $135.9K | $899.84 | 2.92x |
| 26145 | Repair of tendon, finger and/or hand | 348 | $134.4K | $386.21 | 3.30x |
| 64721 | Release and/or relocation of median nerve of hand | 346 | $114.5K | $331.06 | 3.19x |
| 73110 | X-ray of wrist, minimum of 3 views | 3.0K | $99.5K | $33.60 | 2.42x |
| 73030 | X-ray of shoulder, minimum of 2 views | 2.8K | $75.6K | $27.42 | 2.43x |
| 73130 | X-ray of hand, minimum of 3 views | 2.2K | $63.9K | $29.40 | 2.37x |
| 73562 | X-ray of knee, 3 views | 1.4K | $47.3K | $32.95 | 2.39x |
| 20606 | Aspiration and/or injection of intermediate joint or joint capsule with recording and reporting using ultrasound guidance | 643 | $44.6K | $69.30 | 2.53x |
| 20526 | Injection of carpal tunnel | 630 | $42.9K | $68.12 | 2.68x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 758 | $40.4K | $53.31 | 3.62x |
| 76882 | Ultrasound of arm or leg | 874 | $36.2K | $41.36 | 3.64x |
| 25609 | Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments | 33 | $28.7K | $870.48 | 3.49x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 3.4K | $26.7K | $7.96 | 3.21x |
This provider submits charges 3 times higher than what Medicare actually pays.
A markup ratio of 3x means for every $100 Medicare pays, this provider initially charges $300. 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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