This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Sports Medicine providers nationally.
Medicare payments to this provider grew 65% 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 | $214.47 | $40.27 | 5.33x | $174.20 | $342.0K | 5.1K | 1.7K |
| 2015 | $238.62 | $41.72 | 5.72x | $196.90 | $327.8K | 4.9K | 1.9K |
| 2016 | $248.03 | $39.74 | 6.24x | $208.29 | $419.3K | 6.5K | 2.2K |
| 2017 | $272.00 | $40.81 | 6.67x | $231.19 | $469.0K | 7.8K | 2.5K |
| 2018 | $245.28 | $71.15 | 3.45x | $174.13 | $502.5K | 8.6K | 2.9K |
| 2019 | $186.93 | $90.18 | 2.07x | $96.75 | $715.1K | 10.6K | 3.3K |
| 2020 | $142.30 | $38.62 | 3.68x | $103.68 | $441.6K | 8.3K | 2.7K |
| 2021 | $161.23 | $45.39 | 3.55x | $115.84 | $581.9K | 10.7K | 3.1K |
| 2022 | $173.52 | $42.86 | 4.05x | $130.66 | $627.4K | 11.3K | 3.5K |
| 2023 | $184.69 | $45.68 | 4.04x | $139.01 | $565.4K | 11.5K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 16.5K | $2.0M | $122.57 | 5.82x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 32.8K | $1.5M | $45.87 | 3.69x |
| J7321 | Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose | 9.8K | $576.0K | $58.98 | 3.90x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 9.9K | $313.7K | $31.68 | 3.60x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.0K | $233.9K | $57.96 | 2.97x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.5K | $108.3K | $70.26 | 4.27x |
| 73564 | X-ray of knee, 4 or more views | 2.1K | $62.0K | $29.16 | 4.22x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 461 | $42.0K | $91.00 | 2.32x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 250 | $28.8K | $115.19 | 2.73x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 47 | $27.6K | $586.19 | 2.20x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 1.8K | $12.0K | $6.66 | 3.50x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 2.0K | $9.3K | $4.53 | 2.80x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 293 | $8.8K | $30.05 | 5.03x |
| 73030 | X-ray of shoulder, minimum of 2 views | 362 | $7.2K | $19.95 | 4.86x |
| 20551 | Injections of tendon attachment to bone | 167 | $6.4K | $38.25 | 4.68x |
| 73721 | MRI scan of leg joint | 49 | $6.0K | $122.87 | 4.99x |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 1.1K | $5.6K | $5.11 | 69.58x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 74 | $5.4K | $72.42 | 4.02x |
| J7322 | Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg | 167 | $3.3K | $19.49 | 1.36x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 48 | $2.2K | $44.93 | 6.31x |
This provider submits charges 4.61 times higher than what Medicare actually pays.
A markup ratio of 4.61x means for every $100 Medicare pays, this provider initially charges $461. 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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