This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.58x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 57% from 2014 to 2023.
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 | $1.6K | $231.52 | 6.86x | $1.4K | $324.0K | 3.6K | 2.5K |
| 2015 | $1.5K | $241.98 | 6.23x | $1.3K | $332.9K | 3.6K | 2.7K |
| 2016 | $2.0K | $303.14 | 6.75x | $1.7K | $447.8K | 3.5K | 2.5K |
| 2017 | $1.8K | $238.68 | 7.61x | $1.6K | $376.8K | 3.3K | 2.5K |
| 2018 | $1.8K | $219.09 | 8.10x | $1.6K | $402.4K | 3.7K | 2.8K |
| 2019 | $1.8K | $246.38 | 7.50x | $1.6K | $434.1K | 3.8K | 2.8K |
| 2020 | $1.7K | $234.39 | 7.40x | $1.5K | $347.2K | 3.1K | 2.4K |
| 2021 | $2.1K | $302.32 | 7.03x | $1.8K | $387.0K | 2.8K | 2.3K |
| 2022 | $1.6K | $227.50 | 6.89x | $1.3K | $521.8K | 5.2K | 4.1K |
| 2023 | $1.5K | $207.00 | 7.26x | $1.3K | $507.3K | 5.3K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 390 | $532.8K | $1.4K | 5.86x |
| 62323 | Injection of substance into spinal canal of lower back or sacrum using imaging guidance | 2.5K | $473.8K | $187.35 | 3.13x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.3K | $435.1K | $81.51 | 2.45x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.4K | $359.4K | $56.12 | 2.25x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 191 | $250.1K | $1.3K | 5.77x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 1.5K | $227.8K | $150.47 | 6.32x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 422 | $202.0K | $478.75 | 13.65x |
| 62311 | Injections of substances into lower or sacral spine | 1.4K | $186.7K | $133.58 | 5.05x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 245 | $142.9K | $583.20 | 9.15x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 194 | $112.6K | $580.35 | 9.73x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 3.5K | $91.6K | $25.81 | 5.54x |
| 63655 | Implantation of spinal neurostimulator electrodes | 144 | $91.4K | $634.62 | 8.80x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.2K | $86.4K | $73.36 | 2.61x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 143 | $80.4K | $562.42 | 9.29x |
| 22634 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 152 | $57.6K | $378.73 | 6.41x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 68 | $57.6K | $846.56 | 7.23x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 186 | $57.3K | $308.17 | 6.84x |
| 20937 | Harvest of bone fragments for spine surgery graft | 444 | $56.8K | $127.98 | 9.37x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 412 | $49.0K | $118.99 | 2.41x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 269 | $43.7K | $162.41 | 10.38x |
This provider submits charges 5.58 times higher than what Medicare actually pays.
A markup ratio of 5.58x means for every $100 Medicare pays, this provider initially charges $558. 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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