This provider's $9.9M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 6.64x is significantly above the specialty median of 4.7x.
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 | $1.1K | $149.42 | 7.44x | $962.84 | $938.7K | 6.4K | 5.8K |
| 2015 | $1.5K | $193.26 | 7.87x | $1.3K | $974.8K | 6.9K | 6.1K |
| 2016 | $1.4K | $183.02 | 7.48x | $1.2K | $1.0M | 5.6K | 5.1K |
| 2017 | $1.4K | $176.48 | 7.98x | $1.2K | $855.3K | 4.7K | 4.4K |
| 2018 | $2.0K | $250.26 | 7.83x | $1.7K | $988.5K | 6.1K | 5.6K |
| 2019 | $1.9K | $257.17 | 7.42x | $1.7K | $1.0M | 6.4K | 5.8K |
| 2020 | $2.1K | $273.84 | 7.77x | $1.9K | $921.0K | 6.5K | 5.9K |
| 2021 | $1.4K | $221.71 | 6.24x | $1.2K | $966.5K | 7.8K | 6.8K |
| 2022 | $1.3K | $182.52 | 7.19x | $1.1K | $1.1M | 8.5K | 7.4K |
| 2023 | $1.6K | $231.99 | 6.85x | $1.4K | $1.2M | 8.9K | 7.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 3.1K | $3.9M | $1.3K | 8.36x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 2.0K | $2.3M | $1.2K | 7.78x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.2K | $801.5K | $87.02 | 2.53x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.3K | $652.4K | $57.97 | 3.10x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 5.5K | $267.2K | $48.28 | 3.11x |
| 73562 | X-ray of knee, 3 views | 10.3K | $263.6K | $25.62 | 3.37x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.2K | $240.2K | $75.12 | 4.26x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 141 | $230.4K | $1.6K | 7.35x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $198.4K | $119.87 | 3.34x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 5.6K | $175.9K | $31.43 | 2.93x |
| 27486 | Revision of one component of total knee joint prosthesis | 124 | $151.2K | $1.2K | 8.30x |
| 27137 | Revision of hip joint prosthesis | 92 | $108.9K | $1.2K | 8.45x |
| 73564 | X-ray of knee, 4 or more views | 3.9K | $107.2K | $27.37 | 3.82x |
| 73522 | X-ray of both hips with pelvis, 3-4 views | 1.4K | $52.7K | $37.63 | 3.21x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 1.0K | $48.8K | $48.27 | 6.80x |
| 77073 | Imaging for bone length assessment | 1.8K | $46.3K | $25.43 | 3.76x |
| 27446 | Repair of knee joint | 46 | $45.7K | $993.34 | 9.45x |
| 72170 | X-ray of pelvis, 1 or 2 views | 2.0K | $42.0K | $20.74 | 4.59x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 60 | $39.7K | $661.17 | 2.65x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 26 | $39.7K | $1.5K | 8.02x |
This provider submits charges 6.64 times higher than what Medicare actually pays.
A markup ratio of 6.64x means for every $100 Medicare pays, this provider initially charges $664. 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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