This provider's $6.3M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 10.38x 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 | $3.7K | $194.57 | 19.06x | $3.5K | $615.0K | 9.5K | 4.3K |
| 2015 | $4.1K | $222.78 | 18.28x | $3.8K | $732.3K | 11.3K | 4.8K |
| 2016 | $4.3K | $229.32 | 18.65x | $4.0K | $641.7K | 7.7K | 4.5K |
| 2017 | $3.7K | $177.61 | 20.92x | $3.5K | $590.6K | 7.4K | 4.2K |
| 2018 | $3.5K | $188.77 | 18.44x | $3.3K | $548.7K | 7.9K | 4.6K |
| 2019 | $3.4K | $196.05 | 17.39x | $3.2K | $659.1K | 7.5K | 4.4K |
| 2020 | $4.0K | $224.60 | 17.97x | $3.8K | $486.9K | 8.0K | 4.0K |
| 2021 | $3.6K | $197.99 | 18.11x | $3.4K | $728.9K | 12.2K | 4.9K |
| 2022 | $2.3K | $139.26 | 16.75x | $2.2K | $613.0K | 10.8K | 4.7K |
| 2023 | $3.0K | $153.33 | 19.55x | $2.8K | $679.6K | 13.5K | 5.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 888 | $1.0M | $1.1K | 15.36x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 16.7K | $994.7K | $59.45 | 8.70x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 4.3K | $661.6K | $152.44 | 2.26x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.7K | $597.2K | $61.86 | 3.05x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 528 | $596.7K | $1.1K | 32.91x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.4K | $302.9K | $88.08 | 2.98x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 10.4K | $223.6K | $21.44 | 5.64x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $192.5K | $124.58 | 3.01x |
| 64445 | Injection of anesthetic agent, sciatic nerve | 1.2K | $152.5K | $125.97 | 14.20x |
| 73562 | X-ray of knee, 3 views | 4.4K | $136.4K | $31.24 | 5.65x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 3.5K | $126.9K | $36.73 | 6.17x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.3K | $109.4K | $82.28 | 3.49x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 115 | $104.2K | $906.33 | 14.35x |
| 97530 | Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes | 3.5K | $104.2K | $29.90 | 3.69x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 5.3K | $97.3K | $18.44 | 5.66x |
| 23472 | Prosthetic repair of shoulder joint | 78 | $96.6K | $1.2K | 14.31x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 91 | $87.5K | $961.56 | 1.56x |
| 97150 | Therapeutic procedures in a group setting | 7.0K | $82.7K | $11.86 | 6.20x |
| 73564 | X-ray of knee, 4 or more views | 1.9K | $68.5K | $35.74 | 5.38x |
| 73030 | X-ray of shoulder, minimum of 2 views | 2.0K | $52.0K | $25.91 | 7.23x |
This provider submits charges 10.38 times higher than what Medicare actually pays.
A markup ratio of 10.38x means for every $100 Medicare pays, this provider initially charges $1038. 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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