This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Hand Surgery providers nationally.
Their average markup ratio of 6.61x is significantly above the specialty median of 4.4x.
Medicare payments to this provider grew 113% 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 | $938.64 | $141.19 | 6.65x | $797.45 | $225.4K | 2.9K | 2.4K |
| 2015 | $979.51 | $136.00 | 7.20x | $843.51 | $273.5K | 3.3K | 2.8K |
| 2016 | $833.84 | $114.28 | 7.30x | $719.56 | $270.3K | 3.3K | 2.8K |
| 2017 | $1.1K | $135.14 | 8.00x | $946.36 | $316.7K | 3.6K | 2.9K |
| 2018 | $1.2K | $121.49 | 9.67x | $1.1K | $307.5K | 3.5K | 3.0K |
| 2019 | $1.4K | $150.46 | 9.09x | $1.2K | $353.3K | 4.2K | 3.5K |
| 2020 | $1.3K | $140.93 | 9.44x | $1.2K | $326.1K | 4.0K | 3.2K |
| 2021 | $1.6K | $173.92 | 9.24x | $1.4K | $481.1K | 4.9K | 4.1K |
| 2022 | $1.2K | $146.19 | 8.07x | $1.0K | $422.7K | 4.5K | 3.8K |
| 2023 | $1.1K | $178.65 | 6.41x | $967.30 | $480.0K | 5.0K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 25115 | Removal of fluid-filled sac (bursa) of wrist joint lining or forearm tendon | 1.1K | $787.0K | $746.00 | 7.75x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.9K | $423.2K | $144.25 | 5.45x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.6K | $378.4K | $103.72 | 5.00x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.1K | $353.4K | $69.12 | 4.91x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.9K | $277.2K | $94.37 | 4.90x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 4.2K | $195.1K | $46.74 | 6.02x |
| 73130 | X-ray of hand, minimum of 3 views | 3.9K | $124.2K | $31.71 | 5.77x |
| 25609 | Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments | 117 | $123.3K | $1.1K | 7.71x |
| 26055 | Incision of tendon covering | 488 | $119.3K | $244.44 | 13.03x |
| 73110 | X-ray of wrist, minimum of 3 views | 2.6K | $94.2K | $35.82 | 5.62x |
| 25600 | Closed treatment of broken forearm bones | 205 | $67.8K | $330.67 | 4.69x |
| 99205 | New patient outpatient visit, total time 60-74 minutes | 273 | $53.2K | $195.04 | 5.93x |
| 26145 | Repair of tendon, finger and/or hand | 155 | $43.1K | $277.84 | 15.72x |
| 20605 | Aspiration and/or injection of medium joint or joint capsule | 944 | $42.8K | $45.39 | 6.12x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 262 | $41.5K | $158.48 | 5.45x |
| 20600 | Aspiration and/or injection of small joint or joint capsule | 812 | $34.1K | $42.04 | 5.92x |
| 26341 | Manipulation of palm pretendinous cord following enzyme injection | 298 | $30.5K | $102.45 | 10.30x |
| J0702 | Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg | 5.7K | $29.1K | $5.10 | 7.71x |
| 20527 | Injection of enzyme in palm tissue | 302 | $24.4K | $80.76 | 5.44x |
| 25447 | Removal of bone joints between wrist and fingers | 31 | $23.4K | $753.95 | 8.13x |
This provider submits charges 6.61 times higher than what Medicare actually pays.
A markup ratio of 6.61x means for every $100 Medicare pays, this provider initially charges $661. 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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