This provider's $4.1M 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.
Notable: Payments increased 57% in 2021
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 | $139.71 | $48.52 | 2.88x | $91.19 | $278.1K | 4.0K | 2.2K |
| 2015 | $138.01 | $47.64 | 2.90x | $90.37 | $389.4K | 5.8K | 3.3K |
| 2016 | $152.30 | $51.11 | 2.98x | $101.19 | $441.0K | 6.8K | 3.8K |
| 2017 | $150.72 | $50.00 | 3.01x | $100.72 | $403.8K | 7.9K | 4.3K |
| 2018 | $152.91 | $51.03 | 3.00x | $101.88 | $512.5K | 8.2K | 4.6K |
| 2019 | $163.71 | $59.63 | 2.75x | $104.08 | $557.2K | 7.3K | 4.1K |
| 2020 | $160.51 | $52.91 | 3.03x | $107.60 | $308.1K | 5.1K | 3.1K |
| 2021 | $155.91 | $54.50 | 2.86x | $101.41 | $484.3K | 6.8K | 3.9K |
| 2022 | $275.07 | $51.96 | 5.29x | $223.11 | $387.9K | 5.8K | 3.2K |
| 2023 | $404.03 | $67.00 | 6.03x | $337.03 | $345.4K | 6.0K | 3.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 10.0K | $1.3M | $127.00 | 2.85x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 17.8K | $1.1M | $61.33 | 5.51x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.8K | $452.1K | $58.20 | 2.46x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.7K | $295.1K | $80.03 | 2.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.9K | $282.5K | $95.81 | 3.86x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $181.8K | $129.75 | 4.41x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 1.3K | $143.4K | $111.75 | 3.22x |
| 73564 | X-ray of knee, 4 or more views | 3.3K | $121.8K | $36.52 | 3.69x |
| 20551 | Injections of tendon attachment to bone | 2.1K | $93.9K | $45.50 | 4.71x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.6K | $42.6K | $26.11 | 4.22x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 814 | $29.0K | $35.69 | 3.35x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 572 | $19.9K | $34.78 | 2.16x |
| 73562 | X-ray of knee, 3 views | 624 | $18.6K | $29.74 | 2.79x |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 6.5K | $7.7K | $1.18 | 2.83x |
| J7329 | Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg | 845 | $6.2K | $7.37 | 3.88x |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 949 | $5.6K | $5.92 | 2.56x |
| 73080 | X-ray of elbow, minimum of 3 views | 191 | $5.0K | $26.39 | 4.18x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 164 | $4.9K | $29.93 | 3.68x |
| 73501 | X-ray of hip with pelvis, 1 view | 159 | $4.4K | $27.88 | 4.43x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 129 | $4.0K | $31.06 | 3.16x |
This provider submits charges 3.77 times higher than what Medicare actually pays.
A markup ratio of 3.77x means for every $100 Medicare pays, this provider initially charges $377. 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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