This provider's $3.3M in total Medicare payments ranks in the 98th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 73% from 2014 to 2023.
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 | $159.23 | $41.64 | 3.82x | $117.59 | $254.1K | 5.9K | 4.0K |
| 2015 | $184.13 | $44.68 | 4.12x | $139.45 | $236.9K | 5.5K | 3.8K |
| 2016 | $181.85 | $44.18 | 4.12x | $137.67 | $252.9K | 5.7K | 3.9K |
| 2017 | $171.83 | $42.73 | 4.02x | $129.10 | $290.7K | 6.5K | 4.6K |
| 2018 | $198.25 | $46.06 | 4.30x | $152.19 | $273.8K | 6.3K | 4.4K |
| 2019 | $234.09 | $51.77 | 4.52x | $182.32 | $339.9K | 7.4K | 5.2K |
| 2020 | $165.25 | $43.32 | 3.81x | $121.93 | $364.2K | 7.8K | 5.4K |
| 2021 | $179.09 | $46.11 | 3.88x | $132.98 | $433.7K | 8.4K | 5.7K |
| 2022 | $161.22 | $43.82 | 3.68x | $117.40 | $428.4K | 8.5K | 6.0K |
| 2023 | $191.43 | $45.35 | 4.22x | $146.08 | $438.6K | 8.7K | 6.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 20.3K | $1.2M | $59.89 | 2.41x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 6.6K | $418.3K | $63.36 | 2.29x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.4K | $254.2K | $74.30 | 2.58x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 4.5K | $221.8K | $49.64 | 3.84x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.8K | $167.4K | $94.96 | 2.40x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 672 | $85.0K | $126.49 | 2.47x |
| J0897 | Injection, denosumab, 1 mg | 5.2K | $83.5K | $16.14 | 1.43x |
| 73564 | X-ray of knee, 4 or more views | 2.0K | $74.8K | $36.95 | 3.03x |
| 73721 | MRI scan of leg joint | 505 | $64.2K | $127.05 | 7.34x |
| 72148 | MRI scan of lower spinal canal | 572 | $63.3K | $110.62 | 8.51x |
| 72114 | X-ray lower and sacral spine including bending views minimum 6 views | 1.4K | $63.3K | $45.89 | 3.70x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.6K | $40.5K | $25.33 | 3.30x |
| 77080 | Dxa bone density measurement of hip, pelvis, spine | 863 | $33.6K | $38.91 | 2.07x |
| 72020 | X-ray of spine, 1 view | 1.5K | $28.4K | $19.06 | 2.20x |
| 72052 | X-ray of upper spine, 6 or more views | 628 | $28.1K | $44.71 | 3.69x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 778 | $26.3K | $33.82 | 2.27x |
| 73221 | MRI scan of arm joint | 211 | $26.0K | $123.27 | 7.54x |
| 73110 | X-ray of wrist, minimum of 3 views | 741 | $22.3K | $30.12 | 2.96x |
| 77085 | Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment | 393 | $20.9K | $53.12 | 2.00x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 451 | $17.6K | $38.93 | 3.17x |
This provider submits charges 2.89 times higher than what Medicare actually pays.
A markup ratio of 2.89x means for every $100 Medicare pays, this provider initially charges $289. 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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