This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery 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 | $978.41 | $178.50 | 5.48x | $799.91 | $492.8K | 5.5K | 4.5K |
| 2015 | $872.11 | $162.52 | 5.37x | $709.59 | $620.4K | 7.2K | 5.3K |
| 2016 | $1.1K | $211.11 | 5.45x | $938.86 | $595.0K | 5.9K | 4.6K |
| 2017 | $1.1K | $208.86 | 5.22x | $881.17 | $593.7K | 5.4K | 4.4K |
| 2018 | $1.4K | $259.32 | 5.33x | $1.1K | $518.8K | 4.2K | 3.4K |
| 2019 | $1.2K | $210.81 | 5.70x | $991.58 | $438.3K | 3.6K | 3.1K |
| 2020 | $1.2K | $213.51 | 5.66x | $994.47 | $423.9K | 3.3K | 2.8K |
| 2021 | $1.1K | $201.40 | 5.23x | $851.99 | $412.7K | 3.4K | 2.9K |
| 2022 | $1.1K | $212.08 | 5.04x | $857.11 | $380.3K | 3.6K | 3.2K |
| 2023 | $1.1K | $210.85 | 5.18x | $880.41 | $377.1K | 4.4K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 933 | $1.0M | $1.1K | 6.34x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 918 | $992.8K | $1.1K | 6.01x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.1K | $584.5K | $81.76 | 2.60x |
| 27446 | Repair of knee joint | 468 | $440.5K | $941.25 | 5.97x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 5.9K | $310.8K | $52.78 | 2.92x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.9K | $276.0K | $55.83 | 2.67x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 1.9K | $248.7K | $131.43 | 2.21x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 236 | $156.0K | $660.83 | 2.58x |
| 73562 | X-ray of knee, 3 views | 5.2K | $136.0K | $26.13 | 3.65x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.8K | $131.9K | $72.81 | 2.68x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 4.0K | $117.8K | $29.74 | 3.56x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 956 | $104.0K | $108.83 | 2.40x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 734 | $88.0K | $119.91 | 4.52x |
| 73560 | X-ray of knee, 1 or 2 views | 2.1K | $45.8K | $21.79 | 3.64x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 378 | $42.9K | $113.53 | 3.74x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.9K | $36.6K | $19.41 | 4.55x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.2K | $28.3K | $24.36 | 3.99x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 27 | $24.0K | $889.88 | 5.64x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 790 | $20.3K | $25.65 | 3.35x |
| J0702 | Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg | 3.6K | $18.0K | $4.95 | 3.44x |
This provider submits charges 4.54 times higher than what Medicare actually pays.
A markup ratio of 4.54x means for every $100 Medicare pays, this provider initially charges $454. 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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