This provider's $3.3M in total Medicare payments ranks in the 98th 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 | $854.05 | $224.49 | 3.80x | $629.56 | $367.4K | 3.3K | 2.4K |
| 2015 | $935.34 | $223.25 | 4.19x | $712.09 | $363.6K | 2.6K | 2.2K |
| 2016 | $943.74 | $206.60 | 4.57x | $737.14 | $314.2K | 2.1K | 1.9K |
| 2017 | $1.1K | $215.37 | 4.88x | $835.31 | $320.5K | 2.3K | 2.0K |
| 2018 | $1.2K | $289.85 | 4.02x | $874.56 | $362.4K | 2.2K | 2.0K |
| 2019 | $1.4K | $314.47 | 4.39x | $1.1K | $319.5K | 2.2K | 1.8K |
| 2020 | $1.9K | $336.29 | 5.73x | $1.6K | $300.0K | 1.9K | 1.6K |
| 2021 | $1.3K | $230.13 | 5.73x | $1.1K | $306.4K | 1.6K | 1.4K |
| 2022 | $1.3K | $227.56 | 5.78x | $1.1K | $308.3K | 1.6K | 1.4K |
| 2023 | $1.9K | $336.80 | 5.74x | $1.6K | $313.2K | 1.7K | 1.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 23472 | Prosthetic repair of shoulder joint | 1.1K | $1.3M | $1.2K | 4.07x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 842 | $700.9K | $832.40 | 3.93x |
| 29828 | Release of shoulder biceps tendon using an endoscope | 626 | $245.3K | $391.84 | 7.15x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.4K | $243.8K | $55.48 | 4.22x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.1K | $176.2K | $83.21 | 4.31x |
| 29826 | Shaving of shoulder bone using an endoscope | 976 | $134.8K | $138.08 | 8.63x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.7K | $129.4K | $76.82 | 4.06x |
| 73030 | X-ray of shoulder, minimum of 2 views | 4.6K | $108.3K | $23.47 | 4.30x |
| 23474 | Revision of total shoulder repair | 66 | $90.1K | $1.4K | 4.16x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 1.7K | $80.0K | $48.41 | 4.22x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 377 | $47.4K | $125.61 | 5.45x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 699 | $14.5K | $20.80 | 3.85x |
| 29823 | Extensive removal of shoulder joint tissue using an endoscope | 79 | $14.0K | $177.37 | 9.98x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 76 | $12.2K | $160.73 | 10.60x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 196 | $6.5K | $33.00 | 4.25x |
| 73562 | X-ray of knee, 3 views | 165 | $4.7K | $28.40 | 4.19x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 39 | $3.4K | $87.93 | 4.95x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 96 | $1.8K | $19.11 | 3.92x |
| 97001 | Physical therapy evaluation | 29 | $1.7K | $58.52 | 3.20x |
| 73070 | X-ray of elbow, 2 views | 59 | $1.2K | $20.95 | 3.98x |
This provider submits charges 4.57 times higher than what Medicare actually pays.
A markup ratio of 4.57x means for every $100 Medicare pays, this provider initially charges $457. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data