This provider's $3.7M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 66% 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 | $328.40 | $79.57 | 4.13x | $248.83 | $292.1K | 4.3K | 2.2K |
| 2015 | $346.88 | $74.75 | 4.64x | $272.13 | $300.9K | 4.1K | 2.3K |
| 2016 | $404.67 | $96.40 | 4.20x | $308.27 | $369.4K | 4.8K | 2.5K |
| 2017 | $307.00 | $79.68 | 3.85x | $227.32 | $379.8K | 5.2K | 2.7K |
| 2018 | $293.79 | $75.07 | 3.91x | $218.72 | $348.2K | 4.5K | 2.4K |
| 2019 | $273.37 | $94.75 | 2.89x | $178.62 | $458.4K | 5.2K | 2.7K |
| 2020 | $163.03 | $97.33 | 1.68x | $65.70 | $308.3K | 3.7K | 1.8K |
| 2021 | $134.25 | $83.61 | 1.61x | $50.64 | $379.4K | 4.6K | 2.3K |
| 2022 | $400.04 | $73.40 | 5.45x | $326.64 | $403.3K | 4.8K | 2.4K |
| 2023 | $488.16 | $57.05 | 8.56x | $431.11 | $485.2K | 6.0K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 10.9K | $1.1M | $99.56 | 5.52x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.5K | $655.4K | $100.41 | 4.42x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.7K | $335.6K | $72.09 | 4.96x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 2.9K | $315.2K | $110.16 | 3.41x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 4.1K | $267.6K | $65.74 | 3.81x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 353 | $213.7K | $605.38 | 2.40x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.6K | $150.7K | $91.97 | 4.45x |
| 73562 | X-ray of knee, 3 views | 3.2K | $119.1K | $37.53 | 4.09x |
| 73721 | MRI scan of leg joint | 409 | $64.1K | $156.68 | 6.05x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 230 | $54.3K | $235.99 | 1.85x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 784 | $53.1K | $67.79 | 5.19x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 948 | $50.1K | $52.89 | 5.17x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.3K | $45.2K | $34.12 | 4.69x |
| 72148 | MRI scan of lower spinal canal | 311 | $44.4K | $142.65 | 6.55x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.2K | $36.9K | $30.05 | 4.42x |
| 73221 | MRI scan of arm joint | 217 | $34.3K | $158.01 | 5.96x |
| 92548 | Assessment of balance and postural instability | 345 | $31.9K | $92.32 | 2.45x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 783 | $31.8K | $40.59 | 4.12x |
| 72040 | X-ray of spine of neck, 2 or 3 views | 580 | $18.8K | $32.46 | 4.22x |
| 72141 | MRI scan of upper spinal canal | 97 | $13.8K | $142.06 | 6.59x |
This provider submits charges 4.57 times higher than what Medicare actually pays.
A markup ratio of 4.57x means for every $100 Medicare pays, this provider initially charges $457. 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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