This provider's $5.3M 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 | $1.1K | $224.97 | 4.88x | $873.60 | $425.1K | 5.5K | 3.4K |
| 2015 | $460.76 | $154.44 | 2.98x | $306.32 | $480.4K | 5.9K | 4.0K |
| 2016 | $692.01 | $238.81 | 2.90x | $453.20 | $570.1K | 5.8K | 3.7K |
| 2017 | $745.80 | $244.72 | 3.05x | $501.08 | $572.1K | 5.8K | 4.0K |
| 2018 | $918.84 | $218.99 | 4.20x | $699.85 | $559.3K | 6.0K | 4.2K |
| 2019 | $998.99 | $251.87 | 3.97x | $747.12 | $554.6K | 6.0K | 4.0K |
| 2020 | $776.71 | $179.53 | 4.33x | $597.18 | $474.2K | 5.6K | 3.5K |
| 2021 | $967.76 | $203.56 | 4.75x | $764.20 | $552.5K | 6.3K | 3.9K |
| 2022 | $934.50 | $195.32 | 4.78x | $739.18 | $554.6K | 6.6K | 4.0K |
| 2023 | $1.2K | $198.41 | 6.04x | $1.0K | $586.2K | 7.0K | 4.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.5K | $1.6M | $1.1K | 4.60x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 688 | $717.6K | $1.0K | 4.48x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 12.5K | $656.1K | $52.64 | 3.59x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 5.5K | $611.8K | $110.61 | 3.30x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.7K | $587.8K | $76.63 | 2.68x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.8K | $418.0K | $53.62 | 2.58x |
| 73562 | X-ray of knee, 3 views | 8.5K | $218.2K | $25.67 | 3.43x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $119.2K | $112.29 | 2.81x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 3.3K | $100.3K | $29.99 | 2.75x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 73 | $99.6K | $1.4K | 3.54x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 847 | $60.0K | $70.87 | 2.88x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 640 | $43.8K | $68.38 | 3.17x |
| 73560 | X-ray of knee, 1 or 2 views | 1.6K | $37.2K | $23.05 | 3.47x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 720 | $18.8K | $26.06 | 3.79x |
| 72170 | X-ray of pelvis, 1 or 2 views | 730 | $14.2K | $19.51 | 4.80x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 347 | $13.6K | $39.24 | 2.68x |
| 73523 | X-ray of both hips with pelvis, minimum of 5 views | 301 | $11.9K | $39.68 | 3.28x |
| 27425 | Release of ligaments of knee joint, open procedure | 41 | $6.9K | $167.50 | 5.25x |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 5.9K | $6.5K | $1.11 | 5.16x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 202 | $6.4K | $31.65 | 2.72x |
This provider submits charges 3.74 times higher than what Medicare actually pays.
A markup ratio of 3.74x means for every $100 Medicare pays, this provider initially charges $374. 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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