This provider's $7.2M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.6x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 93% 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 | $699.63 | $138.27 | 5.06x | $561.36 | $470.6K | 6.6K | 3.9K |
| 2015 | $763.31 | $133.21 | 5.73x | $630.10 | $582.7K | 6.0K | 3.8K |
| 2016 | $749.02 | $124.66 | 6.01x | $624.36 | $676.9K | 6.7K | 4.1K |
| 2017 | $1.1K | $162.59 | 6.82x | $945.91 | $735.4K | 7.2K | 4.4K |
| 2018 | $940.03 | $134.03 | 7.01x | $806.00 | $658.5K | 6.8K | 4.3K |
| 2019 | $831.78 | $130.09 | 6.39x | $701.69 | $757.8K | 7.1K | 4.7K |
| 2020 | $966.36 | $149.69 | 6.46x | $816.67 | $582.7K | 5.7K | 3.9K |
| 2021 | $1.2K | $191.73 | 6.15x | $988.26 | $858.2K | 7.4K | 4.7K |
| 2022 | $1.0K | $159.71 | 6.35x | $853.85 | $931.6K | 8.0K | 5.1K |
| 2023 | $1.1K | $144.68 | 7.87x | $993.35 | $907.2K | 8.2K | 5.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 3.3K | $2.2M | $660.11 | 5.13x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 16.6K | $1.7M | $101.50 | 5.63x |
| 27447 | Repair of knee joint | 466 | $616.8K | $1.3K | 5.87x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.4K | $591.9K | $70.25 | 5.94x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 4.6K | $420.3K | $90.81 | 4.98x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.0K | $284.6K | $145.19 | 5.84x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 4.1K | $234.9K | $56.87 | 6.20x |
| 73562 | X-ray of knee, 3 views | 5.3K | $224.8K | $42.27 | 5.50x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 835 | $77.0K | $92.19 | 5.75x |
| 73030 | X-ray of shoulder, minimum of 2 views | 2.2K | $70.5K | $31.83 | 6.01x |
| 73564 | X-ray of knee, 4 or more views | 1.1K | $69.9K | $61.09 | 5.17x |
| 29828 | Release of shoulder biceps tendon using an endoscope | 93 | $66.8K | $718.80 | 6.40x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.9K | $66.4K | $34.69 | 6.11x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 327 | $53.5K | $163.71 | 3.84x |
| 29880 | Removal of both knee cartilages using an endoscope | 105 | $49.9K | $475.28 | 6.80x |
| 73560 | X-ray of knee, 1 or 2 views | 1.6K | $47.1K | $29.18 | 5.83x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.5K | $42.9K | $27.76 | 5.86x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 1.1K | $42.6K | $40.40 | 5.62x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 396 | $40.8K | $102.96 | 4.59x |
| J3490 | Unclassified drugs | 37 | $37.3K | $1.0K | 4.10x |
This provider submits charges 5.6 times higher than what Medicare actually pays.
A markup ratio of 5.6x means for every $100 Medicare pays, this provider initially charges $560. 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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