This provider's $5.2M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 92% 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 | $583.90 | $134.98 | 4.33x | $448.92 | $312.4K | 4.8K | 3.3K |
| 2015 | $639.73 | $151.67 | 4.22x | $488.06 | $358.4K | 5.2K | 3.6K |
| 2016 | $580.23 | $134.62 | 4.31x | $445.61 | $377.3K | 5.0K | 3.5K |
| 2017 | $500.95 | $144.03 | 3.48x | $356.92 | $422.0K | 5.5K | 3.9K |
| 2018 | $533.85 | $164.45 | 3.25x | $369.40 | $531.7K | 6.1K | 4.1K |
| 2019 | $539.34 | $171.32 | 3.15x | $368.02 | $743.8K | 7.1K | 4.6K |
| 2020 | $598.31 | $180.47 | 3.32x | $417.84 | $577.4K | 6.3K | 3.9K |
| 2021 | $614.90 | $181.12 | 3.39x | $433.78 | $584.3K | 6.0K | 4.3K |
| 2022 | $653.06 | $188.91 | 3.46x | $464.15 | $649.3K | 5.9K | 4.0K |
| 2023 | $651.37 | $195.09 | 3.34x | $456.28 | $600.1K | 5.9K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 815 | $1.1M | $1.3K | 3.58x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 10.4K | $648.4K | $62.41 | 3.24x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 434 | $579.5K | $1.3K | 3.54x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 3.8K | $518.6K | $136.32 | 6.80x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.3K | $480.9K | $143.69 | 3.36x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.8K | $413.2K | $71.12 | 3.31x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.9K | $310.6K | $105.97 | 3.38x |
| 73564 | X-ray of knee, 4 or more views | 4.5K | $223.3K | $49.22 | 2.95x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 4.8K | $188.9K | $39.54 | 3.24x |
| 73562 | X-ray of knee, 3 views | 3.1K | $109.9K | $35.17 | 3.34x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.5K | $105.2K | $41.86 | 3.02x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 856 | $82.6K | $96.47 | 3.28x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 2.1K | $72.5K | $34.88 | 3.43x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 445 | $66.5K | $149.45 | 3.12x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.1K | $35.5K | $31.83 | 3.07x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 521 | $35.2K | $67.58 | 4.97x |
| 72040 | X-ray of spine of neck, 2 or 3 views | 742 | $24.4K | $32.86 | 3.48x |
| 72170 | X-ray of pelvis, 1 or 2 views | 868 | $22.7K | $26.18 | 3.02x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 219 | $22.7K | $103.43 | 3.13x |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 2.1K | $20.9K | $9.75 | 3.08x |
This provider submits charges 3.76 times higher than what Medicare actually pays.
A markup ratio of 3.76x means for every $100 Medicare pays, this provider initially charges $376. 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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