This provider's $6.1M 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 | $808.16 | $183.57 | 4.40x | $624.59 | $463.3K | 7.4K | 5.1K |
| 2015 | $982.04 | $211.67 | 4.64x | $770.37 | $536.4K | 8.2K | 5.9K |
| 2016 | $1.2K | $272.55 | 4.52x | $958.17 | $588.6K | 9.0K | 6.5K |
| 2017 | $931.95 | $212.49 | 4.39x | $719.46 | $747.7K | 9.5K | 6.6K |
| 2018 | $1.0K | $186.26 | 5.43x | $825.54 | $612.6K | 8.5K | 6.1K |
| 2019 | $873.15 | $183.68 | 4.75x | $689.47 | $681.3K | 8.2K | 5.6K |
| 2020 | $731.45 | $207.60 | 3.52x | $523.85 | $669.8K | 7.8K | 5.0K |
| 2021 | $615.28 | $195.70 | 3.14x | $419.58 | $670.0K | 7.8K | 5.1K |
| 2022 | $581.21 | $165.05 | 3.52x | $416.16 | $560.9K | 7.5K | 4.8K |
| 2023 | $584.00 | $151.70 | 3.85x | $432.30 | $563.6K | 7.3K | 4.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.2K | $1.2M | $1.0K | 4.38x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 1.2K | $814.4K | $667.57 | 3.24x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 804 | $809.4K | $1.0K | 4.52x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 14.2K | $757.4K | $53.28 | 3.25x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 14.5K | $666.7K | $46.03 | 3.62x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.7K | $497.2K | $74.21 | 3.09x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.0K | $304.8K | $102.96 | 3.43x |
| 73562 | X-ray of knee, 3 views | 8.9K | $230.6K | $25.88 | 3.66x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 4.3K | $129.3K | $29.86 | 3.35x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 163 | $114.2K | $700.61 | 2.15x |
| 73503 | X-ray of hip with pelvis, minimum of 4 views | 2.3K | $83.6K | $36.57 | 4.53x |
| 73560 | X-ray of knee, 1 or 2 views | 3.9K | $81.4K | $20.96 | 3.26x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.7K | $78.0K | $29.39 | 4.04x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 39 | $51.2K | $1.3K | 4.19x |
| 73721 | MRI scan of leg joint | 305 | $33.5K | $109.96 | 7.51x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 467 | $31.0K | $66.48 | 2.43x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 1.1K | $27.9K | $26.37 | 3.26x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.1K | $22.5K | $19.66 | 3.77x |
| 29881 | Removal of one knee cartilage using an endoscope | 56 | $21.7K | $387.35 | 6.37x |
| 73523 | X-ray of both hips with pelvis, minimum of 5 views | 469 | $19.0K | $40.55 | 3.95x |
This provider submits charges 3.77 times higher than what Medicare actually pays.
A markup ratio of 3.77x means for every $100 Medicare pays, this provider initially charges $377. 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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