This provider's $4.6M 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.
Notable: Payments increased 53% in 2019
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 | $331.03 | $52.88 | 6.26x | $278.15 | $390.2K | 8.1K | 2.4K |
| 2015 | $365.67 | $79.54 | 4.60x | $286.13 | $443.3K | 6.6K | 2.4K |
| 2016 | $400.81 | $77.62 | 5.16x | $323.19 | $557.0K | 7.1K | 2.6K |
| 2017 | $486.57 | $84.24 | 5.78x | $402.33 | $495.2K | 7.2K | 2.5K |
| 2018 | $460.42 | $82.11 | 5.61x | $378.31 | $464.3K | 7.3K | 2.8K |
| 2019 | $497.49 | $129.10 | 3.85x | $368.39 | $710.9K | 7.6K | 2.9K |
| 2020 | $480.25 | $92.98 | 5.17x | $387.27 | $342.9K | 5.8K | 2.1K |
| 2021 | $397.38 | $116.43 | 3.41x | $280.95 | $363.1K | 5.8K | 2.2K |
| 2022 | $441.80 | $74.98 | 5.89x | $366.82 | $362.7K | 5.3K | 2.2K |
| 2023 | $411.20 | $81.37 | 5.05x | $329.83 | $512.9K | 5.1K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 1.9K | $1.3M | $713.89 | 2.58x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 14.9K | $861.7K | $57.70 | 3.31x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 12.4K | $614.9K | $49.49 | 6.64x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 5.2K | $357.5K | $69.06 | 6.88x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 356 | $228.8K | $642.68 | 4.82x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.8K | $154.1K | $83.32 | 3.77x |
| 73560 | X-ray of knee, 1 or 2 views | 5.6K | $142.5K | $25.42 | 6.66x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 945 | $129.2K | $136.74 | 3.20x |
| 20553 | Injections of trigger points in 3 or more muscles | 2.9K | $117.2K | $40.32 | 6.90x |
| Q4206 | Fluid flow or fluid gf, 1 cc | 51 | $84.0K | $1.6K | 1.52x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 3.7K | $77.9K | $20.89 | 4.53x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 817 | $61.1K | $74.84 | 4.84x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 744 | $52.0K | $69.94 | 6.13x |
| 73221 | MRI scan of arm joint | 427 | $51.0K | $119.32 | 10.32x |
| 73721 | MRI scan of leg joint | 410 | $50.1K | $122.09 | 10.18x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 2.8K | $48.4K | $17.47 | 4.20x |
| J3304 | Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg | 2.7K | $37.2K | $13.87 | 3.64x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.1K | $36.4K | $33.30 | 4.51x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 282 | $32.8K | $116.42 | 3.68x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.4K | $31.4K | $23.06 | 7.79x |
This provider submits charges 4.42 times higher than what Medicare actually pays.
A markup ratio of 4.42x means for every $100 Medicare pays, this provider initially charges $442. 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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