This provider's $11.1M 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 | $1.1K | $281.65 | 3.93x | $825.78 | $940.2K | 9.9K | 6.8K |
| 2015 | $862.68 | $275.51 | 3.13x | $587.17 | $983.4K | 10.8K | 7.7K |
| 2016 | $817.78 | $271.25 | 3.01x | $546.53 | $1.2M | 12.6K | 8.9K |
| 2017 | $869.28 | $254.94 | 3.41x | $614.34 | $1.2M | 12.9K | 9.0K |
| 2018 | $1.6K | $300.36 | 5.21x | $1.3K | $1.4M | 12.4K | 8.7K |
| 2019 | $1.4K | $299.97 | 4.77x | $1.1K | $1.4M | 11.4K | 8.1K |
| 2020 | $1.3K | $271.70 | 4.92x | $1.1K | $1.0M | 8.3K | 6.0K |
| 2021 | $1.7K | $356.57 | 4.87x | $1.4K | $1.2M | 8.3K | 6.1K |
| 2022 | $1.4K | $293.08 | 4.92x | $1.1K | $986.7K | 7.4K | 5.4K |
| 2023 | $1.1K | $203.23 | 5.24x | $861.02 | $804.9K | 7.5K | 5.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 23.8K | $2.1M | $86.94 | 3.47x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.7K | $2.0M | $1.2K | 3.70x |
| 27447 | Repair of knee joint | 1.4K | $1.7M | $1.2K | 3.88x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 1.1K | $887.8K | $787.03 | 2.32x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 5.6K | $697.3K | $125.12 | 3.44x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 12.0K | $655.2K | $54.64 | 4.58x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 829 | $630.4K | $760.47 | 3.60x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 182 | $292.7K | $1.6K | 7.11x |
| 72170 | X-ray of pelvis, 1 or 2 views | 11.7K | $271.0K | $23.24 | 3.33x |
| 73565 | X-ray of both knees, standing, front to back view | 7.9K | $223.7K | $28.49 | 2.91x |
| 27245 | Surgical treatment of broken thigh bone | 182 | $192.2K | $1.1K | 3.13x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 1.1K | $183.8K | $159.96 | 3.28x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.8K | $181.2K | $64.00 | 4.07x |
| 73560 | X-ray of knee, 1 or 2 views | 6.5K | $161.1K | $24.84 | 2.84x |
| 12034 | Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs | 1.4K | $124.5K | $91.58 | 5.48x |
| 73562 | X-ray of knee, 3 views | 3.8K | $122.2K | $31.80 | 5.20x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.6K | $87.8K | $34.01 | 4.03x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 77 | $82.6K | $1.1K | 2.44x |
| 27425 | Release of ligaments of knee joint, open procedure | 371 | $75.1K | $202.46 | 6.30x |
| 27486 | Revision of one component of total knee joint prosthesis | 51 | $60.5K | $1.2K | 2.62x |
This provider submits charges 3.7 times higher than what Medicare actually pays.
A markup ratio of 3.7x means for every $100 Medicare pays, this provider initially charges $370. 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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