This provider's $4.7M in total Medicare payments ranks in the 99th percentile of Sports Medicine 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 | $374.33 | $74.37 | 5.03x | $299.96 | $329.1K | 5.5K | 3.8K |
| 2015 | $401.46 | $78.11 | 5.14x | $323.35 | $293.7K | 4.6K | 3.4K |
| 2016 | $365.13 | $71.81 | 5.08x | $293.32 | $376.4K | 6.0K | 4.5K |
| 2017 | $408.76 | $86.14 | 4.75x | $322.62 | $386.0K | 5.8K | 4.3K |
| 2018 | $420.15 | $96.34 | 4.36x | $323.81 | $533.2K | 6.7K | 5.2K |
| 2019 | $393.11 | $108.24 | 3.63x | $284.87 | $540.2K | 6.7K | 5.1K |
| 2020 | $381.13 | $90.36 | 4.22x | $290.77 | $545.7K | 5.8K | 4.3K |
| 2021 | $394.46 | $98.03 | 4.02x | $296.43 | $675.3K | 6.5K | 4.8K |
| 2022 | $416.29 | $102.44 | 4.06x | $313.85 | $552.6K | 6.2K | 4.6K |
| 2023 | $412.82 | $86.89 | 4.75x | $325.93 | $446.1K | 6.1K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.7K | $832.0K | $85.95 | 2.85x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 912 | $761.9K | $835.40 | 2.21x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 4.5K | $523.8K | $115.20 | 2.75x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 5.4K | $407.5K | $75.76 | 3.87x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 507 | $368.2K | $726.15 | 2.66x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 5.0K | $227.4K | $45.08 | 3.54x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.6K | $218.0K | $60.12 | 2.85x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.0K | $124.2K | $120.03 | 2.96x |
| 72148 | MRI scan of lower spinal canal | 681 | $120.6K | $177.07 | 9.30x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.6K | $111.7K | $69.39 | 3.46x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 1.9K | $95.4K | $50.74 | 5.09x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 1.4K | $95.1K | $68.03 | 4.56x |
| 73721 | MRI scan of leg joint | 457 | $83.5K | $182.82 | 7.92x |
| 73562 | X-ray of knee, 3 views | 2.5K | $77.4K | $31.38 | 3.56x |
| 73221 | MRI scan of arm joint | 334 | $62.2K | $186.27 | 7.77x |
| J3490 | Unclassified drugs | 81 | $53.9K | $666.03 | 2.70x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.8K | $52.3K | $29.18 | 4.73x |
| 72141 | MRI scan of upper spinal canal | 230 | $41.0K | $178.36 | 8.55x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.6K | $39.7K | $24.16 | 3.77x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 252 | $38.8K | $153.97 | 2.90x |
This provider submits charges 3.44 times higher than what Medicare actually pays.
A markup ratio of 3.44x means for every $100 Medicare pays, this provider initially charges $344. 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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