This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 78% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 55% in 2022
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $1.7K | $200.93 | 8.55x | $1.5K | $315.9K | 5.2K | 3.4K |
| 2015 | $1.5K | $182.95 | 8.34x | $1.3K | $362.0K | 5.9K | 3.7K |
| 2016 | $1.3K | $171.14 | 7.46x | $1.1K | $401.7K | 6.4K | 3.9K |
| 2017 | $1.2K | $176.04 | 6.85x | $1.0K | $403.5K | 6.0K | 3.6K |
| 2018 | $1.4K | $193.49 | 7.24x | $1.2K | $425.1K | 6.0K | 3.7K |
| 2019 | $1.3K | $205.01 | 6.27x | $1.1K | $390.0K | 5.3K | 3.1K |
| 2020 | $735.83 | $139.49 | 5.28x | $596.34 | $280.2K | 4.3K | 2.5K |
| 2021 | $936.57 | $175.21 | 5.35x | $761.36 | $415.6K | 4.8K | 2.8K |
| 2022 | $295.82 | $111.38 | 2.66x | $184.44 | $642.4K | 5.6K | 3.0K |
| 2023 | $356.10 | $130.37 | 2.73x | $225.73 | $562.7K | 4.8K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 1.7K | $1.0M | $597.89 | 2.44x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 14.3K | $860.5K | $60.29 | 2.65x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 11.6K | $684.3K | $58.87 | 6.01x |
| 27447 | Repair of knee joint | 379 | $477.3K | $1.3K | 8.21x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 160 | $187.7K | $1.2K | 9.96x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.7K | $153.4K | $91.24 | 2.70x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 333 | $138.8K | $416.92 | 2.18x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.3K | $110.5K | $82.61 | 2.74x |
| 73564 | X-ray of knee, 4 or more views | 2.6K | $96.4K | $36.57 | 3.51x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 9.8K | $76.6K | $7.85 | 2.70x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 637 | $68.7K | $107.82 | 2.35x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 417 | $54.4K | $130.46 | 2.86x |
| 73562 | X-ray of knee, 3 views | 1.5K | $45.3K | $30.30 | 3.34x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 36 | $36.4K | $1.0K | 8.62x |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 3.3K | $30.4K | $9.32 | 2.68x |
| 29880 | Removal of both knee cartilages using an endoscope | 50 | $23.5K | $470.01 | 12.39x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 627 | $22.1K | $35.25 | 4.69x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 157 | $20.7K | $131.64 | 2.24x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 348 | $10.9K | $31.40 | 3.76x |
| 29881 | Removal of one knee cartilage using an endoscope | 22 | $9.9K | $448.33 | 10.75x |
This provider submits charges 4.27 times higher than what Medicare actually pays.
A markup ratio of 4.27x means for every $100 Medicare pays, this provider initially charges $427. 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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