This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Sports Medicine 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 | $818.98 | $139.55 | 5.87x | $679.43 | $284.8K | 4.1K | 3.1K |
| 2015 | $729.70 | $130.46 | 5.59x | $599.24 | $217.9K | 3.6K | 2.6K |
| 2016 | $895.51 | $172.85 | 5.18x | $722.66 | $291.0K | 3.9K | 2.9K |
| 2017 | $1.0K | $168.24 | 5.95x | $832.05 | $311.0K | 4.0K | 2.8K |
| 2018 | $1.0K | $189.24 | 5.31x | $815.03 | $342.2K | 3.9K | 2.8K |
| 2019 | $839.25 | $165.09 | 5.08x | $674.16 | $389.5K | 3.9K | 2.8K |
| 2020 | $810.84 | $164.77 | 4.92x | $646.07 | $321.2K | 3.5K | 2.6K |
| 2021 | $734.05 | $128.64 | 5.71x | $605.41 | $390.6K | 4.0K | 3.0K |
| 2022 | $796.78 | $159.04 | 5.01x | $637.74 | $466.8K | 4.5K | 3.2K |
| 2023 | $842.22 | $162.19 | 5.19x | $680.03 | $411.1K | 4.1K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 1.0K | $639.6K | $628.89 | 2.39x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.8K | $443.2K | $64.94 | 3.70x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.1K | $284.8K | $92.81 | 3.82x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 4.9K | $279.4K | $56.59 | 4.32x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $188.6K | $132.18 | 4.08x |
| 23472 | Prosthetic repair of shoulder joint | 142 | $179.6K | $1.3K | 3.86x |
| 27447 | Repair of knee joint | 145 | $165.6K | $1.1K | 4.02x |
| 76881 | Ultrasound of leg or arm | 1.2K | $97.1K | $84.31 | 4.76x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 721 | $90.5K | $125.45 | 4.25x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 988 | $86.0K | $86.99 | 4.09x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 887 | $76.3K | $86.02 | 4.03x |
| 29879 | Repair of knee joint using an endoscope | 106 | $52.4K | $494.73 | 4.51x |
| 23430 | Anchoring of biceps tendon | 158 | $52.0K | $328.87 | 7.64x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.9K | $51.9K | $27.91 | 3.56x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 156 | $49.4K | $316.51 | 7.02x |
| 27435 | Incision of back portion of knee joint capsule | 138 | $48.4K | $350.61 | 7.60x |
| 27245 | Surgical treatment of broken thigh bone | 44 | $46.7K | $1.1K | 3.81x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 53 | $46.4K | $875.43 | 3.97x |
| 23455 | Reattachment of shoulder joint capsule and cartilage | 100 | $44.1K | $441.37 | 7.63x |
| 27301 | Drainage of abscess or blood collection at thigh or knee region | 158 | $35.0K | $221.55 | 10.17x |
This provider submits charges 4.2 times higher than what Medicare actually pays.
A markup ratio of 4.2x means for every $100 Medicare pays, this provider initially charges $420. 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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