This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Sports Medicine providers nationally.
Medicare payments to this provider grew 63% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 91% in 2019
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 | $649.28 | $116.84 | 5.56x | $532.44 | $265.3K | 4.1K | 2.9K |
| 2015 | $665.84 | $118.27 | 5.63x | $547.57 | $235.4K | 4.2K | 3.3K |
| 2016 | $854.62 | $174.41 | 4.90x | $680.21 | $312.8K | 4.9K | 3.8K |
| 2017 | $908.35 | $169.89 | 5.35x | $738.46 | $307.5K | 5.0K | 3.9K |
| 2018 | $859.13 | $146.34 | 5.87x | $712.79 | $291.6K | 4.1K | 3.2K |
| 2019 | $914.79 | $196.53 | 4.65x | $718.26 | $556.7K | 4.3K | 3.4K |
| 2020 | $930.91 | $211.57 | 4.40x | $719.34 | $546.3K | 3.8K | 3.0K |
| 2021 | $892.37 | $201.84 | 4.42x | $690.53 | $691.6K | 4.2K | 3.2K |
| 2022 | $828.26 | $186.41 | 4.44x | $641.85 | $606.2K | 4.7K | 3.5K |
| 2023 | $673.76 | $154.30 | 4.37x | $519.46 | $432.1K | 4.3K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 1.6K | $1.3M | $783.63 | 2.35x |
| 27447 | Repair of knee joint | 741 | $721.7K | $973.94 | 4.74x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.2K | $482.3K | $77.90 | 3.34x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.1K | $317.7K | $51.67 | 3.88x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 7.0K | $300.6K | $42.95 | 4.64x |
| 23472 | Prosthetic repair of shoulder joint | 108 | $115.8K | $1.1K | 3.53x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 143 | $108.8K | $760.90 | 4.36x |
| 73562 | X-ray of knee, 3 views | 4.1K | $102.2K | $25.01 | 4.57x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.4K | $98.7K | $68.18 | 4.57x |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 1.2K | $94.4K | $75.91 | 5.55x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 808 | $94.4K | $116.84 | 3.11x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 882 | $89.8K | $101.83 | 3.73x |
| 27446 | Repair of knee joint | 86 | $74.3K | $863.90 | 4.30x |
| 29880 | Removal of both knee cartilages using an endoscope | 133 | $53.0K | $398.33 | 5.08x |
| 73721 | MRI scan of leg joint | 336 | $37.5K | $111.48 | 7.35x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.7K | $35.2K | $20.95 | 4.63x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.1K | $31.9K | $29.52 | 4.30x |
| 73221 | MRI scan of arm joint | 228 | $25.4K | $111.39 | 7.39x |
| 29826 | Shaving of shoulder bone using an endoscope | 178 | $23.6K | $132.46 | 15.27x |
| 72148 | MRI scan of lower spinal canal | 223 | $22.3K | $100.09 | 9.75x |
This provider submits charges 3.84 times higher than what Medicare actually pays.
A markup ratio of 3.84x means for every $100 Medicare pays, this provider initially charges $384. 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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