This provider's $3.6M 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 | $1.1K | $135.88 | 8.41x | $1.0K | $279.3K | 4.2K | 3.4K |
| 2015 | $1.1K | $136.41 | 8.21x | $983.19 | $302.4K | 4.4K | 3.4K |
| 2016 | $1.1K | $146.69 | 7.58x | $964.97 | $312.3K | 4.5K | 3.4K |
| 2017 | $733.90 | $136.56 | 5.37x | $597.34 | $285.7K | 3.7K | 2.8K |
| 2018 | $915.16 | $140.20 | 6.53x | $774.96 | $410.2K | 4.5K | 3.3K |
| 2019 | $616.11 | $121.28 | 5.08x | $494.83 | $420.9K | 4.1K | 3.0K |
| 2020 | $651.71 | $120.10 | 5.43x | $531.61 | $335.4K | 3.7K | 2.7K |
| 2021 | $677.34 | $160.48 | 4.22x | $516.86 | $459.1K | 4.0K | 2.9K |
| 2022 | $640.06 | $139.29 | 4.60x | $500.77 | $386.7K | 3.4K | 2.5K |
| 2023 | $719.11 | $146.05 | 4.92x | $573.06 | $404.8K | 3.7K | 2.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 571 | $700.5K | $1.2K | 8.22x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 1.1K | $688.5K | $639.31 | 2.42x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 8.9K | $543.5K | $60.84 | 5.81x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.0K | $382.9K | $96.86 | 2.59x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.1K | $366.5K | $59.79 | 2.62x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $218.0K | $127.18 | 2.77x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 288 | $154.0K | $534.87 | 2.03x |
| 73564 | X-ray of knee, 4 or more views | 2.8K | $105.9K | $38.13 | 3.35x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 793 | $91.8K | $115.80 | 2.25x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 77 | $81.6K | $1.1K | 11.03x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 6.4K | $51.5K | $8.01 | 2.68x |
| 73562 | X-ray of knee, 3 views | 1.4K | $43.1K | $31.78 | 3.20x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 191 | $29.6K | $154.89 | 2.36x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 748 | $25.7K | $34.39 | 2.47x |
| 73030 | X-ray of shoulder, minimum of 2 views | 759 | $21.0K | $27.72 | 3.84x |
| 29880 | Removal of both knee cartilages using an endoscope | 27 | $13.2K | $487.52 | 11.95x |
| 72170 | X-ray of pelvis, 1 or 2 views | 426 | $11.0K | $25.71 | 4.17x |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 1.1K | $10.0K | $9.54 | 2.61x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 104 | $9.2K | $88.55 | 2.61x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 123 | $9.2K | $74.71 | 2.52x |
This provider submits charges 4.41 times higher than what Medicare actually pays.
A markup ratio of 4.41x means for every $100 Medicare pays, this provider initially charges $441. 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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