This provider's $5.3M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.95x 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 | $1.0K | $307.36 | 3.33x | $715.31 | $545.1K | 2.7K | 2.3K |
| 2015 | $1.6K | $325.73 | 5.03x | $1.3K | $663.3K | 3.6K | 2.9K |
| 2016 | $2.0K | $306.99 | 6.58x | $1.7K | $678.8K | 4.5K | 3.5K |
| 2017 | $1.7K | $262.33 | 6.46x | $1.4K | $553.3K | 3.9K | 3.0K |
| 2018 | $1.6K | $249.56 | 6.45x | $1.4K | $621.2K | 4.6K | 3.3K |
| 2019 | $1.8K | $289.72 | 6.20x | $1.5K | $562.3K | 3.2K | 2.6K |
| 2020 | $2.1K | $321.69 | 6.50x | $1.8K | $452.2K | 1.8K | 1.6K |
| 2021 | $4.3K | $351.96 | 12.28x | $4.0K | $388.4K | 1.9K | 1.7K |
| 2022 | $2.0K | $358.76 | 5.58x | $1.6K | $357.1K | 1.8K | 1.5K |
| 2023 | $1.0K | $335.33 | 3.11x | $708.44 | $444.8K | 2.0K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 673 | $852.2K | $1.3K | 5.29x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 345 | $469.1K | $1.4K | 5.28x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 662 | $401.6K | $606.61 | 5.32x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 665 | $374.4K | $562.96 | 10.65x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 527 | $338.1K | $641.63 | 5.08x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.1K | $315.2K | $77.59 | 5.20x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 521 | $246.8K | $473.68 | 10.31x |
| 22846 | Insertion of anterior spinal instrumentation for spinal stabilization, 4 to 7 vertebral segments | 372 | $238.3K | $640.58 | 4.28x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.3K | $225.1K | $52.67 | 4.42x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 630 | $207.9K | $330.08 | 5.02x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 659 | $140.9K | $213.82 | 5.51x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 386 | $133.1K | $344.80 | 4.03x |
| 27279 | Fusion sacroiliac joint through the skin or minimally invasive using image guidance | 161 | $106.9K | $664.12 | 5.23x |
| 22585 | Fusion of spine bones with removal of disc, anterior approach | 587 | $104.0K | $177.21 | 7.55x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 996 | $102.3K | $102.72 | 5.36x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 4.0K | $98.2K | $24.53 | 6.19x |
| 22552 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 272 | $89.7K | $329.60 | 5.06x |
| 27280 | Fusion of sacroiliac joint | 60 | $61.9K | $1.0K | 3.56x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 389 | $57.4K | $147.52 | 4.96x |
| 22610 | Fusion of middle spine bones, posterior or posterolateral approach | 78 | $52.1K | $667.61 | 7.04x |
This provider submits charges 5.95 times higher than what Medicare actually pays.
A markup ratio of 5.95x means for every $100 Medicare pays, this provider initially charges $595. 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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