This provider's $7.5M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 50% 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 | $4.1K | $254.63 | 15.94x | $3.8K | $550.3K | 5.9K | 4.3K |
| 2015 | $1.7K | $314.71 | 5.30x | $1.4K | $693.0K | 6.7K | 4.9K |
| 2016 | $788.20 | $391.90 | 2.01x | $396.30 | $740.1K | 6.6K | 4.8K |
| 2017 | $696.11 | $350.42 | 1.99x | $345.69 | $743.0K | 6.8K | 4.8K |
| 2018 | $616.58 | $375.54 | 1.64x | $241.04 | $763.3K | 7.0K | 5.1K |
| 2019 | $528.75 | $352.21 | 1.50x | $176.54 | $792.7K | 7.1K | 5.1K |
| 2020 | $650.99 | $415.39 | 1.57x | $235.60 | $720.2K | 5.8K | 4.2K |
| 2021 | $487.31 | $305.12 | 1.60x | $182.19 | $845.6K | 6.4K | 4.7K |
| 2022 | $953.83 | $303.22 | 3.15x | $650.61 | $823.0K | 6.4K | 4.7K |
| 2023 | $2.8K | $260.75 | 10.58x | $2.5K | $826.4K | 6.9K | 5.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.2K | $1.6M | $1.3K | 4.66x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 900 | $1.2M | $1.3K | 4.86x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12.3K | $855.7K | $69.80 | 3.32x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 11.8K | $768.3K | $65.22 | 3.65x |
| 27245 | Surgical treatment of broken thigh bone | 298 | $371.3K | $1.2K | 3.60x |
| 23472 | Prosthetic repair of shoulder joint | 227 | $332.6K | $1.5K | 4.04x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.2K | $319.6K | $142.75 | 2.79x |
| 73564 | X-ray of knee, 4 or more views | 6.0K | $249.5K | $41.28 | 3.34x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.5K | $236.8K | $94.22 | 3.30x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 5.0K | $198.1K | $39.31 | 3.25x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 1.2K | $175.3K | $148.19 | 2.64x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.5K | $151.0K | $103.65 | 3.97x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 119 | $144.2K | $1.2K | 2.96x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.8K | $114.6K | $41.06 | 2.96x |
| 99284 | Emergency department visit, problem of high severity | 967 | $106.8K | $110.47 | 2.85x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 61 | $102.9K | $1.7K | 2.48x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 32 | $58.6K | $1.8K | 1.42x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 488 | $58.2K | $119.24 | 4.13x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.7K | $50.5K | $30.00 | 4.03x |
| 29881 | Removal of one knee cartilage using an endoscope | 91 | $49.7K | $545.83 | 7.93x |
This provider submits charges 3.93 times higher than what Medicare actually pays.
A markup ratio of 3.93x means for every $100 Medicare pays, this provider initially charges $393. 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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