This provider's $8.9M 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 | $215.21 | 4.99x | $858.35 | $890.0K | 7.6K | 6.0K |
| 2015 | $1.3K | $229.26 | 5.54x | $1.0K | $960.1K | 8.1K | 6.4K |
| 2016 | $1.0K | $191.74 | 5.40x | $844.42 | $1.0M | 9.2K | 7.2K |
| 2017 | $1.6K | $257.17 | 6.06x | $1.3K | $1.1M | 8.8K | 7.0K |
| 2018 | $1.5K | $254.25 | 5.71x | $1.2K | $1.0M | 8.5K | 6.7K |
| 2019 | $1.9K | $314.40 | 5.94x | $1.6K | $970.8K | 7.4K | 5.8K |
| 2020 | $1.3K | $226.44 | 5.53x | $1.0K | $693.7K | 6.1K | 4.8K |
| 2021 | $1.4K | $229.04 | 6.27x | $1.2K | $791.3K | 7.1K | 5.6K |
| 2022 | $1.5K | $253.18 | 6.05x | $1.3K | $816.5K | 7.0K | 5.6K |
| 2023 | $1.1K | $219.78 | 5.16x | $914.71 | $683.2K | 5.8K | 4.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 3.2K | $4.0M | $1.2K | 4.56x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.5K | $1.7M | $1.1K | 4.07x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 15.3K | $812.6K | $53.23 | 2.67x |
| 73562 | X-ray of knee, 3 views | 12.8K | $349.8K | $27.36 | 3.38x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 6.6K | $207.9K | $31.56 | 2.85x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.9K | $205.9K | $108.82 | 2.84x |
| 73564 | X-ray of knee, 4 or more views | 6.6K | $202.9K | $30.97 | 3.51x |
| 73560 | X-ray of knee, 1 or 2 views | 7.0K | $165.3K | $23.67 | 3.25x |
| 27486 | Revision of one component of total knee joint prosthesis | 178 | $164.4K | $923.60 | 9.29x |
| 73721 | MRI scan of leg joint | 946 | $120.5K | $127.41 | 8.83x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.6K | $113.3K | $72.54 | 2.81x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.0K | $107.0K | $52.43 | 4.45x |
| 77077 | Imaging of 2 or more joints, single view | 3.4K | $100.7K | $29.78 | 4.24x |
| 27137 | Revision of hip joint prosthesis | 83 | $95.7K | $1.2K | 6.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.2K | $85.0K | $73.89 | 2.72x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 62 | $84.0K | $1.4K | 6.57x |
| 72148 | MRI scan of lower spinal canal | 538 | $60.2K | $111.94 | 10.61x |
| 29880 | Removal of both knee cartilages using an endoscope | 127 | $56.8K | $447.01 | 5.15x |
| 73522 | X-ray of both hips with pelvis, 3-4 views | 1.5K | $53.9K | $36.69 | 2.89x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 1.8K | $46.9K | $26.44 | 3.48x |
This provider submits charges 4.27 times higher than what Medicare actually pays.
A markup ratio of 4.27x means for every $100 Medicare pays, this provider initially charges $427. 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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