This provider's $3.6M 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.
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 | $1.4K | $291.53 | 4.94x | $1.1K | $361.8K | 1.8K | 1.6K |
| 2015 | $1.3K | $293.63 | 4.46x | $1.0K | $298.1K | 1.7K | 1.5K |
| 2016 | $1.2K | $279.39 | 4.41x | $952.32 | $301.2K | 2.4K | 1.9K |
| 2017 | $1.2K | $270.58 | 4.25x | $879.46 | $391.1K | 2.8K | 2.2K |
| 2018 | $1.3K | $322.34 | 3.96x | $953.44 | $439.7K | 2.6K | 2.2K |
| 2019 | $1.3K | $330.85 | 4.00x | $992.26 | $424.8K | 2.3K | 2.0K |
| 2020 | $1.3K | $329.85 | 3.94x | $968.62 | $303.0K | 1.7K | 1.5K |
| 2021 | $1.2K | $294.84 | 3.93x | $862.71 | $335.7K | 2.2K | 1.9K |
| 2022 | $1.1K | $278.77 | 4.10x | $863.41 | $338.0K | 1.9K | 1.8K |
| 2023 | $1.2K | $283.34 | 4.11x | $880.58 | $413.8K | 2.0K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 494 | $695.1K | $1.4K | 3.87x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 243 | $315.9K | $1.3K | 3.98x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.8K | $263.0K | $55.02 | 3.42x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 437 | $258.9K | $592.38 | 3.35x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.1K | $258.7K | $84.13 | 3.30x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 199 | $229.4K | $1.2K | 3.77x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 319 | $176.3K | $552.54 | 6.10x |
| 72148 | MRI scan of lower spinal canal | 1.2K | $174.2K | $147.97 | 8.37x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 228 | $128.9K | $565.37 | 3.32x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 574 | $115.7K | $201.64 | 4.28x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 189 | $110.0K | $582.15 | 3.34x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 689 | $81.5K | $118.29 | 3.59x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 266 | $79.8K | $300.16 | 4.18x |
| 22634 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 210 | $79.0K | $376.42 | 3.90x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 2.2K | $78.8K | $36.13 | 3.48x |
| 72141 | MRI scan of upper spinal canal | 453 | $65.5K | $144.64 | 8.01x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 206 | $60.8K | $295.36 | 4.49x |
| 72114 | X-ray lower and sacral spine including bending views minimum 6 views | 1.1K | $47.7K | $44.87 | 3.82x |
| 22830 | Exploration of spinal fusion | 130 | $42.8K | $329.09 | 7.14x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 251 | $40.8K | $162.48 | 4.62x |
This provider submits charges 4.22 times higher than what Medicare actually pays.
A markup ratio of 4.22x means for every $100 Medicare pays, this provider initially charges $422. 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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