This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 8.94x is significantly above the specialty median of 4.7x.
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 | $4.7K | $233.47 | 20.04x | $4.4K | $326.8K | 3.3K | 2.3K |
| 2015 | $6.0K | $290.90 | 20.58x | $5.7K | $356.0K | 3.4K | 2.6K |
| 2016 | $5.7K | $321.95 | 17.72x | $5.4K | $431.6K | 3.3K | 2.5K |
| 2017 | $4.5K | $258.13 | 17.56x | $4.3K | $391.4K | 3.2K | 2.6K |
| 2018 | $6.3K | $341.37 | 18.52x | $6.0K | $456.7K | 3.3K | 2.5K |
| 2019 | $5.0K | $326.74 | 15.18x | $4.6K | $477.1K | 3.3K | 2.6K |
| 2020 | $1.1K | $320.64 | 3.41x | $771.65 | $388.4K | 3.0K | 2.4K |
| 2021 | $959.42 | $279.01 | 3.44x | $680.41 | $464.8K | 3.6K | 2.9K |
| 2022 | $1.2K | $318.77 | 3.67x | $849.82 | $360.9K | 2.8K | 2.2K |
| 2023 | $1.1K | $311.64 | 3.61x | $813.45 | $454.4K | 3.0K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 669 | $808.3K | $1.2K | 13.78x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.0K | $629.5K | $63.15 | 2.35x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 468 | $566.3K | $1.2K | 21.63x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 805 | $517.8K | $643.17 | 1.89x |
| 27245 | Surgical treatment of broken thigh bone | 334 | $371.3K | $1.1K | 7.58x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.3K | $194.5K | $85.62 | 2.69x |
| 27125 | Partial replacement of thigh bone at hip joint with prosthesis | 162 | $165.9K | $1.0K | 21.58x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.8K | $158.5K | $57.56 | 4.44x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.1K | $117.5K | $103.46 | 2.29x |
| 73564 | X-ray of knee, 4 or more views | 2.6K | $94.2K | $36.25 | 4.39x |
| 72170 | X-ray of pelvis, 1 or 2 views | 2.8K | $71.4K | $25.36 | 5.36x |
| 73562 | X-ray of knee, 3 views | 2.1K | $67.8K | $32.77 | 4.22x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 287 | $47.7K | $166.21 | 2.68x |
| 27236 | Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement | 47 | $47.2K | $1.0K | 4.02x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 330 | $45.3K | $137.14 | 2.66x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 220 | $22.8K | $103.82 | 1.68x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 490 | $20.5K | $41.92 | 5.04x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 13 | $19.0K | $1.5K | 25.01x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 12 | $18.6K | $1.5K | 17.79x |
| 73560 | X-ray of knee, 1 or 2 views | 486 | $14.0K | $28.79 | 4.20x |
This provider submits charges 8.94 times higher than what Medicare actually pays.
A markup ratio of 8.94x means for every $100 Medicare pays, this provider initially charges $894. 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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