This provider's $8.5M 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 | $1.2K | $221.32 | 5.39x | $971.64 | $634.9K | 6.5K | 4.9K |
| 2015 | $1.5K | $288.95 | 5.03x | $1.2K | $727.7K | 7.3K | 5.2K |
| 2016 | $1.5K | $283.37 | 5.28x | $1.2K | $828.8K | 8.3K | 6.0K |
| 2017 | $1.5K | $302.36 | 4.92x | $1.2K | $804.2K | 8.3K | 6.0K |
| 2018 | $1.9K | $373.86 | 5.00x | $1.5K | $910.2K | 8.9K | 6.6K |
| 2019 | $1.8K | $403.95 | 4.50x | $1.4K | $1.0M | 9.4K | 6.9K |
| 2020 | $1.2K | $279.44 | 4.35x | $935.90 | $713.8K | 6.7K | 5.1K |
| 2021 | $1.2K | $266.75 | 4.58x | $954.51 | $952.4K | 7.9K | 5.9K |
| 2022 | $1.3K | $277.79 | 4.61x | $1.0K | $961.2K | 8.0K | 6.1K |
| 2023 | $1.6K | $312.07 | 5.20x | $1.3K | $940.4K | 7.7K | 6.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.8K | $2.2M | $1.2K | 6.03x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.1K | $1.4M | $1.2K | 5.53x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.0K | $756.5K | $94.29 | 1.95x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.8K | $701.5K | $64.72 | 2.27x |
| 27446 | Repair of knee joint | 441 | $470.4K | $1.1K | 6.33x |
| 73565 | X-ray of both knees, standing, front to back view | 11.8K | $390.1K | $32.94 | 3.22x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 463 | $317.1K | $684.98 | 1.91x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 5.2K | $309.7K | $59.01 | 3.37x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.5K | $298.5K | $86.33 | 2.51x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 6.8K | $267.4K | $39.31 | 2.67x |
| 73560 | X-ray of knee, 1 or 2 views | 9.0K | $264.4K | $29.34 | 3.61x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 1.4K | $188.8K | $134.01 | 2.53x |
| 27093 | Injection of dye for X-ray imaging of hip joint | 844 | $166.7K | $197.53 | 2.54x |
| 73562 | X-ray of knee, 3 views | 4.0K | $132.3K | $32.91 | 4.07x |
| 73525 | Radiological supervision and interpretation X-ray of hip joint | 843 | $93.0K | $110.29 | 5.40x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 57 | $90.4K | $1.6K | 5.48x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 48 | $81.2K | $1.7K | 4.35x |
| 73564 | X-ray of knee, 4 or more views | 1.8K | $74.6K | $42.45 | 2.50x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 555 | $73.8K | $132.99 | 2.26x |
| 77073 | Imaging for bone length assessment | 2.0K | $73.0K | $36.05 | 3.36x |
This provider submits charges 4.26 times higher than what Medicare actually pays.
A markup ratio of 4.26x means for every $100 Medicare pays, this provider initially charges $426. 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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