This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 2234% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 434% in 2015
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $549.27 | $97.05 | 5.66x | $452.22 | $26.9K | 328 | 309 |
| 2015 | $526.41 | $128.75 | 4.09x | $397.66 | $143.7K | 2.0K | 1.6K |
| 2016 | $530.55 | $123.38 | 4.30x | $407.17 | $146.5K | 2.1K | 1.7K |
| 2017 | $751.14 | $160.01 | 4.69x | $591.13 | $195.0K | 2.8K | 2.3K |
| 2018 | $603.32 | $172.74 | 3.49x | $430.58 | $291.1K | 3.9K | 3.1K |
| 2019 | $571.67 | $235.77 | 2.42x | $335.90 | $459.9K | 5.0K | 3.8K |
| 2020 | $523.46 | $219.24 | 2.39x | $304.22 | $479.1K | 5.5K | 4.0K |
| 2021 | $500.25 | $233.47 | 2.14x | $266.78 | $584.4K | 6.2K | 4.5K |
| 2022 | $328.27 | $127.36 | 2.58x | $200.91 | $553.6K | 7.0K | 5.0K |
| 2023 | $305.30 | $118.37 | 2.58x | $186.93 | $627.3K | 8.4K | 5.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.7K | $837.7K | $86.06 | 2.73x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 565 | $609.5K | $1.1K | 2.96x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 4.7K | $359.1K | $76.95 | 2.90x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.8K | $324.9K | $116.04 | 2.86x |
| 27447 | Repair of knee joint | 195 | $201.8K | $1.0K | 2.63x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 5.2K | $167.6K | $32.25 | 2.70x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.3K | $124.1K | $54.27 | 2.89x |
| 73564 | X-ray of knee, 4 or more views | 3.8K | $123.9K | $32.61 | 2.67x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.8K | $105.9K | $57.64 | 2.83x |
| 27245 | Surgical treatment of broken thigh bone | 109 | $105.8K | $970.23 | 3.88x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 119 | $104.0K | $873.68 | 1.48x |
| Q4206 | Fluid flow or fluid gf, 1 cc | 56 | $92.3K | $1.6K | 1.82x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 49 | $48.1K | $981.28 | 3.73x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 272 | $43.2K | $158.70 | 2.55x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 4.0K | $35.6K | $8.80 | 2.56x |
| 73562 | X-ray of knee, 3 views | 1.2K | $34.9K | $28.38 | 2.72x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 382 | $28.8K | $75.44 | 3.11x |
| 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 | 637 | $26.8K | $42.04 | 2.50x |
| J3490 | Unclassified drugs | 42 | $19.8K | $472.17 | 2.01x |
| J7322 | Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg | 863 | $18.4K | $21.31 | 3.39x |
This provider submits charges 2.79 times higher than what Medicare actually pays.
A markup ratio of 2.79x means for every $100 Medicare pays, this provider initially charges $279. 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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