This provider's $5.6M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 27746% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 725% in 2016
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $744.50 | $88.22 | 8.44x | $656.28 | $4.4K | 51 | 51 |
| 2016 | $385.48 | $107.94 | 3.57x | $277.54 | $36.2K | 461 | 371 |
| 2017 | $531.98 | $151.37 | 3.51x | $380.61 | $154.8K | 2.3K | 1.6K |
| 2018 | $916.70 | $273.09 | 3.36x | $643.61 | $324.2K | 3.1K | 2.2K |
| 2019 | $1.6K | $470.74 | 3.43x | $1.1K | $637.5K | 4.3K | 3.0K |
| 2020 | $2.1K | $583.49 | 3.66x | $1.6K | $868.9K | 4.8K | 3.3K |
| 2021 | $2.1K | $583.98 | 3.59x | $1.5K | $1.2M | 5.9K | 4.1K |
| 2022 | $2.0K | $555.81 | 3.65x | $1.5K | $1.1M | 6.1K | 4.1K |
| 2023 | $2.3K | $575.87 | 3.95x | $1.7K | $1.2M | 7.9K | 5.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.6K | $738.7K | $63.47 | 2.38x |
| 22513 | Injection of bone cement into body of middle spine bone accessed through the skin using imaging guidance | 142 | $685.5K | $4.8K | 3.94x |
| 22514 | Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance | 123 | $591.3K | $4.8K | 3.95x |
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 254 | $394.1K | $1.6K | 3.20x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 238 | $298.2K | $1.3K | 3.03x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.2K | $268.5K | $121.53 | 2.90x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 405 | $259.1K | $639.70 | 4.07x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.8K | $253.1K | $89.01 | 2.56x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 222 | $217.9K | $981.51 | 3.71x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 283 | $182.4K | $644.45 | 3.13x |
| 63030 | Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine | 162 | $128.0K | $790.06 | 4.03x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 575 | $125.8K | $218.75 | 3.24x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 184 | $119.7K | $650.49 | 3.11x |
| 22515 | Injection of bone cement into body of middle or lower spine bone accessed through the skin using imaging guidance | 45 | $119.3K | $2.7K | 4.52x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 372 | $112.7K | $302.96 | 3.18x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 79 | $108.4K | $1.4K | 3.46x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 3.2K | $87.8K | $27.10 | 3.47x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 126 | $77.8K | $617.24 | 3.17x |
| 22610 | Fusion of middle spine bones, posterior or posterolateral approach | 104 | $74.5K | $715.95 | 4.22x |
| 22843 | Insertion of posterior spinal instrumentation for spinal stabilization, 7 to 12 vertebral segments | 103 | $71.1K | $690.15 | 3.10x |
This provider submits charges 3.34 times higher than what Medicare actually pays.
A markup ratio of 3.34x means for every $100 Medicare pays, this provider initially charges $334. 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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