This provider's $4.0M in total Medicare payments ranks in the 92th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 13.04x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 170% from 2019 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 56% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $10.5K | $984.18 | 10.69x | $9.5K | $507.8K | 769 | 706 |
| 2020 | $11.9K | $1.0K | 11.36x | $10.9K | $576.1K | 703 | 655 |
| 2021 | $11.3K | $805.23 | 13.99x | $10.5K | $636.2K | 882 | 849 |
| 2022 | $17.1K | $1.3K | 13.33x | $15.8K | $879.2K | 970 | 920 |
| 2023 | $19.1K | $1.5K | 12.39x | $17.6K | $1.4M | 964 | 908 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Replacement of knee joint, both sides of knee | 62 | $477.8K | $7.7K | 10.83x |
| 23430 | Anchoring of biceps tendon | 145 | $360.7K | $2.5K | 7.41x |
| 25609 | Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments | 92 | $334.0K | $3.6K | 5.97x |
| 27130 | Replacement of thigh bone and hip joint with prosthesis | 39 | $281.2K | $7.2K | 11.72x |
| 29848 | Release of wrist ligament using an endoscope | 446 | $233.8K | $524.19 | 17.97x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 109 | $224.4K | $2.1K | 9.45x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 700 | $220.4K | $314.91 | 11.88x |
| 23412 | Repair of torn tendons of shoulder, open procedure | 111 | $199.0K | $1.8K | 10.65x |
| 25447 | Removal of bone joints between wrist and fingers | 225 | $180.0K | $800.12 | 20.73x |
| 29881 | Removal of one knee cartilage using an endoscope | 145 | $162.7K | $1.1K | 12.99x |
| 25607 | Open treatment of broken of lower forearm bone or growth plate separation with insertion of hardware | 41 | $144.2K | $3.5K | 5.82x |
| 29880 | Removal of both knee cartilages using an endoscope | 113 | $130.3K | $1.2K | 12.93x |
| 26480 | Transplant of tendon of hand, without graft | 109 | $116.9K | $1.1K | 14.65x |
| 64721 | Release and/or relocation of median nerve of hand | 173 | $113.6K | $656.70 | 18.10x |
| 20680 | Removal of deep bone implant | 99 | $88.7K | $896.41 | 16.32x |
| 26055 | Incision of tendon covering | 185 | $83.9K | $453.50 | 28.99x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 237 | $65.4K | $275.87 | 14.22x |
| 25310 | Relocation of tendon of forearm and/or wrist | 96 | $56.3K | $585.96 | 23.73x |
| 29823 | Extensive removal of shoulder joint tissue using an endoscope | 89 | $54.7K | $615.10 | 25.38x |
| 64718 | Release and/or relocation of ulnar nerve at elbow | 76 | $47.4K | $623.21 | 27.51x |
This provider submits charges 13.04 times higher than what Medicare actually pays.
A markup ratio of 13.04x means for every $100 Medicare pays, this provider initially charges $1304. 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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