This provider's $4.8M 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 | $584.04 | $129.76 | 4.50x | $454.28 | $401.6K | 10.0K | 4.1K |
| 2015 | $551.38 | $125.31 | 4.40x | $426.07 | $405.3K | 9.9K | 4.1K |
| 2016 | $516.95 | $104.44 | 4.95x | $412.51 | $405.8K | 9.1K | 4.3K |
| 2017 | $708.74 | $161.33 | 4.39x | $547.41 | $450.5K | 9.2K | 4.2K |
| 2018 | $611.17 | $135.37 | 4.51x | $475.80 | $438.9K | 9.0K | 3.6K |
| 2019 | $728.52 | $184.08 | 3.96x | $544.44 | $516.9K | 10.7K | 3.8K |
| 2020 | $741.81 | $173.43 | 4.28x | $568.38 | $505.9K | 12.1K | 3.6K |
| 2021 | $701.19 | $167.69 | 4.18x | $533.50 | $552.7K | 12.4K | 3.8K |
| 2022 | $679.15 | $149.07 | 4.56x | $530.08 | $591.3K | 13.7K | 4.3K |
| 2023 | $626.77 | $124.51 | 5.03x | $502.26 | $498.6K | 12.9K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 697 | $762.2K | $1.1K | 4.47x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 18.0K | $355.4K | $19.73 | 4.48x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 322 | $351.2K | $1.1K | 4.55x |
| 97530 | Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes | 12.5K | $347.8K | $27.92 | 3.45x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.4K | $299.4K | $55.35 | 3.78x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 343 | $265.4K | $773.87 | 2.02x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 10.7K | $240.9K | $22.46 | 4.11x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.0K | $238.8K | $80.17 | 3.86x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 4.6K | $215.7K | $46.84 | 4.44x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 1.2K | $153.4K | $125.13 | 3.91x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.8K | $133.2K | $74.00 | 4.25x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 7.6K | $132.8K | $17.39 | 4.79x |
| 27446 | Repair of knee joint | 124 | $119.1K | $960.54 | 3.64x |
| 97150 | Therapeutic procedures in a group setting | 9.4K | $103.5K | $11.02 | 5.17x |
| 97016 | Application of blood vessel compression or decompression device to 1 or more areas | 10.9K | $95.3K | $8.77 | 5.91x |
| 73721 | MRI scan of leg joint | 693 | $90.2K | $130.15 | 8.15x |
| 73221 | MRI scan of arm joint | 499 | $67.6K | $135.45 | 8.28x |
| 73564 | X-ray of knee, 4 or more views | 2.2K | $62.3K | $28.73 | 4.31x |
| 29881 | Removal of one knee cartilage using an endoscope | 136 | $56.4K | $414.99 | 6.06x |
| 97162 | Evaluation of physical therapy, typically 30 minutes | 778 | $53.7K | $68.98 | 3.20x |
This provider submits charges 4.33 times higher than what Medicare actually pays.
A markup ratio of 4.33x means for every $100 Medicare pays, this provider initially charges $433. 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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