This provider's $4.5M 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 | $1.7K | $457.40 | 3.72x | $1.2K | $387.6K | 1.7K | 1.4K |
| 2015 | $1.8K | $476.01 | 3.77x | $1.3K | $411.1K | 1.8K | 1.5K |
| 2016 | $1.9K | $541.00 | 3.47x | $1.3K | $413.0K | 1.6K | 1.3K |
| 2017 | $1.5K | $426.63 | 3.63x | $1.1K | $367.5K | 1.6K | 1.3K |
| 2018 | $1.5K | $429.29 | 3.50x | $1.1K | $390.8K | 1.7K | 1.4K |
| 2019 | $1.6K | $436.63 | 3.58x | $1.1K | $435.9K | 1.8K | 1.5K |
| 2020 | $2.5K | $456.54 | 5.37x | $2.0K | $371.3K | 1.6K | 1.3K |
| 2021 | $1.5K | $434.68 | 3.44x | $1.1K | $523.2K | 2.2K | 1.8K |
| 2022 | $1.6K | $430.85 | 3.73x | $1.2K | $588.5K | 2.6K | 2.1K |
| 2023 | $1.5K | $369.50 | 3.96x | $1.1K | $574.0K | 2.4K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 509 | $727.8K | $1.4K | 3.35x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 558 | $610.9K | $1.1K | 4.16x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 816 | $534.8K | $655.41 | 3.49x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 213 | $322.7K | $1.5K | 3.55x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.2K | $303.9K | $95.05 | 2.57x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 557 | $290.8K | $522.08 | 6.52x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 265 | $182.2K | $687.37 | 3.51x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 247 | $167.4K | $677.90 | 3.37x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.4K | $152.0K | $62.31 | 2.42x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 635 | $148.4K | $233.71 | 4.84x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 843 | $117.3K | $139.10 | 2.95x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 4.0K | $114.8K | $28.93 | 3.67x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 309 | $108.4K | $350.77 | 3.65x |
| 63081 | Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach | 71 | $105.2K | $1.5K | 3.30x |
| 22585 | Fusion of spine bones with removal of disc, anterior approach | 344 | $98.0K | $284.98 | 4.01x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 238 | $85.0K | $357.34 | 3.24x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 949 | $84.7K | $89.26 | 2.77x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 338 | $64.0K | $189.34 | 3.86x |
| 22224 | Incision of spine bone with removal of disc material at lower spinal column | 48 | $63.7K | $1.3K | 3.44x |
| 22552 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 143 | $51.4K | $359.40 | 3.61x |
This provider submits charges 3.73 times higher than what Medicare actually pays.
A markup ratio of 3.73x means for every $100 Medicare pays, this provider initially charges $373. 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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