This provider's $4.0M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 7.43x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 544% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 249% in 2015
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $758.24 | $117.70 | 6.44x | $640.54 | $78.2K | 1.0K | 845 |
| 2015 | $2.3K | $165.29 | 13.81x | $2.1K | $272.4K | 3.7K | 2.6K |
| 2016 | $3.3K | $261.99 | 12.78x | $3.1K | $355.1K | 4.1K | 2.8K |
| 2017 | $3.4K | $248.91 | 13.77x | $3.2K | $354.7K | 4.0K | 2.7K |
| 2018 | $4.0K | $297.60 | 13.32x | $3.7K | $399.9K | 3.5K | 2.6K |
| 2019 | $4.6K | $349.00 | 13.11x | $4.2K | $476.3K | 3.0K | 2.5K |
| 2020 | $3.6K | $283.05 | 12.62x | $3.3K | $398.1K | 2.6K | 2.1K |
| 2021 | $4.3K | $373.49 | 11.57x | $3.9K | $574.0K | 3.2K | 2.7K |
| 2022 | $2.0K | $255.05 | 7.76x | $1.7K | $539.3K | 3.6K | 3.1K |
| 2023 | $1.8K | $237.87 | 7.49x | $1.5K | $503.4K | 3.8K | 3.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 963 | $695.3K | $722.05 | 2.98x |
| 27447 | Repair of knee joint | 441 | $593.1K | $1.3K | 14.50x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.6K | $450.9K | $67.94 | 4.74x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 287 | $382.2K | $1.3K | 15.46x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 4.8K | $251.6K | $51.92 | 6.60x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 1.7K | $221.3K | $127.56 | 3.55x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $217.8K | $143.40 | 5.63x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 221 | $190.5K | $861.81 | 2.20x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.7K | $181.1K | $103.55 | 5.27x |
| 73564 | X-ray of knee, 4 or more views | 3.3K | $130.6K | $40.03 | 6.87x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 616 | $111.0K | $180.23 | 4.11x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.2K | $108.1K | $91.16 | 4.68x |
| 73562 | X-ray of knee, 3 views | 1.9K | $66.5K | $35.62 | 6.04x |
| 73501 | X-ray of hip with pelvis, 1 view | 2.2K | $63.2K | $28.75 | 6.19x |
| 27245 | Surgical treatment of broken thigh bone | 45 | $51.8K | $1.2K | 10.37x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 27 | $47.6K | $1.8K | 18.92x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.3K | $45.7K | $34.61 | 6.88x |
| 73721 | MRI scan of leg joint | 184 | $29.4K | $160.02 | 9.51x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 22 | $25.6K | $1.2K | 9.20x |
| 73502 | X-ray of hip, 2-3 views | 262 | $11.7K | $44.49 | 4.94x |
This provider submits charges 7.43 times higher than what Medicare actually pays.
A markup ratio of 7.43x means for every $100 Medicare pays, this provider initially charges $743. 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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