This provider's $4.9M 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 | $166.00 | $44.81 | 3.70x | $121.19 | $626.3K | 13.7K | 5.5K |
| 2015 | $182.24 | $42.23 | 4.32x | $140.01 | $629.9K | 13.8K | 5.2K |
| 2016 | $172.91 | $41.31 | 4.19x | $131.60 | $677.8K | 15.2K | 5.6K |
| 2017 | $168.40 | $37.04 | 4.55x | $131.36 | $510.3K | 14.9K | 5.4K |
| 2018 | $166.14 | $35.41 | 4.69x | $130.73 | $411.1K | 12.7K | 5.0K |
| 2019 | $179.98 | $43.10 | 4.18x | $136.88 | $540.5K | 12.7K | 4.4K |
| 2020 | $170.63 | $43.11 | 3.96x | $127.52 | $427.8K | 9.4K | 3.3K |
| 2021 | $167.22 | $44.33 | 3.77x | $122.89 | $364.8K | 9.0K | 3.1K |
| 2022 | $161.77 | $43.65 | 3.71x | $118.12 | $356.7K | 9.5K | 3.6K |
| 2023 | $225.57 | $42.97 | 5.25x | $182.60 | $360.1K | 9.2K | 3.6K |
| 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 | 18.8K | $1.2M | $65.83 | 5.65x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.6K | $1.1M | $89.49 | 2.72x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.2K | $744.9K | $66.61 | 2.98x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 5.1K | $351.9K | $69.21 | 4.33x |
| 73562 | X-ray of knee, 3 views | 4.5K | $148.1K | $32.95 | 4.32x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 2.2K | $140.4K | $62.55 | 4.00x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 17.4K | $138.7K | $7.95 | 3.62x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.3K | $107.8K | $83.52 | 3.13x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.3K | $91.6K | $40.30 | 5.04x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 2.1K | $89.6K | $42.85 | 5.23x |
| 20552 | Injections of trigger points in 1 or 2 muscles | 2.3K | $89.1K | $38.53 | 4.82x |
| 20553 | Injections of trigger points in 3 or more muscles | 1.6K | $75.7K | $45.93 | 5.00x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 482 | $57.3K | $118.94 | 1.78x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.8K | $48.9K | $26.65 | 5.59x |
| 20606 | Aspiration and/or injection of intermediate joint or joint capsule with recording and reporting using ultrasound guidance | 687 | $40.4K | $58.81 | 5.73x |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 4.8K | $34.2K | $7.16 | 2.52x |
| 20604 | Aspiration and/or injection of small joint or joint capsule with recording and reporting using ultrasound guidance | 632 | $32.0K | $50.68 | 6.24x |
| J7332 | Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg | 1.7K | $30.7K | $17.78 | 1.63x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 734 | $28.1K | $38.28 | 3.84x |
| 73110 | X-ray of wrist, minimum of 3 views | 863 | $27.6K | $31.96 | 4.01x |
This provider submits charges 4.08 times higher than what Medicare actually pays.
A markup ratio of 4.08x means for every $100 Medicare pays, this provider initially charges $408. 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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