This provider's $4.2M 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 | $195.64 | $54.30 | 3.60x | $141.34 | $306.3K | 5.0K | 3.2K |
| 2015 | $249.86 | $52.23 | 4.78x | $197.63 | $268.8K | 4.7K | 3.2K |
| 2016 | $161.79 | $34.38 | 4.71x | $127.41 | $260.6K | 5.2K | 3.8K |
| 2017 | $237.56 | $48.04 | 4.95x | $189.52 | $290.5K | 5.2K | 3.5K |
| 2018 | $237.33 | $49.82 | 4.76x | $187.51 | $360.4K | 6.1K | 4.1K |
| 2019 | $297.67 | $72.07 | 4.13x | $225.60 | $523.6K | 6.2K | 4.4K |
| 2020 | $461.75 | $117.20 | 3.94x | $344.55 | $552.2K | 4.5K | 3.3K |
| 2021 | $368.59 | $99.47 | 3.71x | $269.12 | $717.3K | 5.3K | 3.9K |
| 2022 | $318.63 | $80.81 | 3.94x | $237.82 | $564.0K | 5.4K | 4.1K |
| 2023 | $361.99 | $68.05 | 5.32x | $293.94 | $360.6K | 5.8K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 1.6K | $1.3M | $823.36 | 2.18x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.4K | $786.3K | $83.56 | 3.54x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 3.5K | $411.0K | $116.99 | 3.04x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 5.5K | $377.8K | $69.15 | 4.29x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 6.7K | $316.9K | $47.19 | 4.00x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.4K | $257.5K | $76.12 | 3.39x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.4K | $193.7K | $57.72 | 2.86x |
| 76881 | Ultrasound of leg or arm | 1.2K | $81.1K | $69.33 | 4.69x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 638 | $75.4K | $118.17 | 4.14x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 1.1K | $53.7K | $49.57 | 7.80x |
| 73564 | X-ray of knee, 4 or more views | 1.3K | $43.6K | $32.49 | 3.79x |
| 64454 | Injection of anesthetic agent and/or steroid into genicular nerve branches of knee using imaging guidance | 288 | $42.7K | $148.17 | 4.98x |
| 64624 | Destruction of genicular nerve branches of knee by injection using imaging guidance | 363 | $40.2K | $110.84 | 9.14x |
| 64640 | Destruction of peripheral nerve or branch | 533 | $28.2K | $52.97 | 8.43x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 858 | $22.1K | $25.76 | 4.52x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.1K | $20.0K | $18.18 | 4.32x |
| 10160 | Aspiration of abscess, blood accumulation, blister, or cyst | 194 | $18.0K | $93.03 | 3.56x |
| 64555 | Implantation of peripheral nerve neurostimulator electrodes, accessed through the skin | 11 | $12.9K | $1.2K | 3.70x |
| 64450 | Injection of anesthetic agent, other peripheral nerve or branch | 413 | $12.3K | $29.68 | 12.24x |
| 73562 | X-ray of knee, 3 views | 857 | $11.6K | $13.51 | 4.62x |
This provider submits charges 3.39 times higher than what Medicare actually pays.
A markup ratio of 3.39x means for every $100 Medicare pays, this provider initially charges $339. 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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