This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 164% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 74% in 2020
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 | $472.43 | $126.67 | 3.73x | $345.76 | $168.8K | 3.2K | 1.9K |
| 2015 | $439.20 | $101.57 | 4.32x | $337.63 | $161.3K | 3.4K | 2.1K |
| 2016 | $292.56 | $73.20 | 4.00x | $219.36 | $156.9K | 3.4K | 2.2K |
| 2017 | $422.21 | $100.13 | 4.22x | $322.08 | $213.3K | 4.4K | 2.7K |
| 2018 | $612.28 | $139.45 | 4.39x | $472.83 | $241.2K | 4.7K | 2.7K |
| 2019 | $718.68 | $187.23 | 3.84x | $531.45 | $389.9K | 4.8K | 3.1K |
| 2020 | $500.64 | $149.26 | 3.35x | $351.38 | $679.9K | 5.6K | 3.4K |
| 2021 | $548.08 | $157.48 | 3.48x | $390.60 | $827.2K | 6.1K | 3.8K |
| 2022 | $501.29 | $127.36 | 3.94x | $373.93 | $650.5K | 6.1K | 3.5K |
| 2023 | $398.35 | $109.60 | 3.63x | $288.75 | $446.4K | 5.9K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 2.1K | $1.6M | $762.96 | 2.24x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 9.9K | $523.1K | $52.77 | 4.20x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.9K | $436.2K | $54.97 | 2.11x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.9K | $359.3K | $93.26 | 2.03x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.6K | $200.6K | $76.81 | 2.74x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 2.0K | $131.2K | $67.15 | 2.68x |
| 29881 | Removal of one knee cartilage using an endoscope | 185 | $79.5K | $429.81 | 4.62x |
| 27245 | Surgical treatment of broken thigh bone | 74 | $75.1K | $1.0K | 3.78x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 450 | $54.8K | $121.82 | 2.49x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 59 | $50.8K | $861.66 | 4.53x |
| 73562 | X-ray of knee, 3 views | 1.5K | $43.6K | $29.13 | 3.21x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.7K | $37.4K | $21.53 | 2.88x |
| 23412 | Repair of torn tendons of shoulder, open procedure | 42 | $28.2K | $672.04 | 4.24x |
| 29822 | Removal of shoulder joint tissue using an endoscope | 70 | $25.1K | $357.89 | 5.59x |
| 29880 | Removal of both knee cartilages using an endoscope | 53 | $23.9K | $451.82 | 4.73x |
| 29826 | Shaving of shoulder bone using an endoscope | 155 | $22.8K | $146.90 | 6.43x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 628 | $21.1K | $33.62 | 2.19x |
| 73110 | X-ray of wrist, minimum of 3 views | 755 | $18.3K | $24.27 | 2.42x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 446 | $17.4K | $39.12 | 4.12x |
| 20605 | Aspiration and/or injection of medium joint or joint capsule | 382 | $14.9K | $39.01 | 4.44x |
This provider submits charges 2.78 times higher than what Medicare actually pays.
A markup ratio of 2.78x means for every $100 Medicare pays, this provider initially charges $278. 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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