This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $536.82 | $157.19 | 3.42x | $379.63 | $431.8K | 4.2K | 3.4K |
| 2015 | $422.65 | $177.10 | 2.39x | $245.55 | $583.5K | 6.0K | 4.3K |
| 2016 | $385.78 | $163.60 | 2.36x | $222.18 | $636.6K | 5.3K | 3.9K |
| 2017 | $384.85 | $161.57 | 2.38x | $223.28 | $653.4K | 5.7K | 4.0K |
| 2018 | $673.48 | $285.71 | 2.36x | $387.77 | $558.1K | 4.6K | 3.5K |
| 2019 | $489.91 | $216.84 | 2.26x | $273.07 | $487.4K | 2.7K | 2.4K |
| 2020 | $452.19 | $202.58 | 2.23x | $249.61 | $359.0K | 1.8K | 1.6K |
| 2021 | $589.10 | $253.22 | 2.33x | $335.88 | $410.9K | 1.7K | 1.5K |
| 2022 | $529.82 | $218.62 | 2.42x | $311.20 | $405.0K | 2.5K | 2.2K |
| 2023 | $548.90 | $226.29 | 2.43x | $322.61 | $491.9K | 3.7K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.5K | $1.7M | $1.1K | 2.45x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.1K | $1.3M | $1.2K | 2.41x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.7K | $498.2K | $87.09 | 2.53x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.9K | $344.5K | $58.03 | 2.56x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 2.3K | $290.7K | $124.11 | 2.43x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 3.6K | $205.1K | $57.70 | 2.81x |
| 73564 | X-ray of knee, 4 or more views | 3.8K | $126.0K | $33.23 | 2.15x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.5K | $119.3K | $78.53 | 2.82x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 3.4K | $112.5K | $33.35 | 2.21x |
| 73562 | X-ray of knee, 3 views | 3.0K | $85.8K | $29.04 | 2.13x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 821 | $28.8K | $35.04 | 2.59x |
| 73521 | X-ray of both hips with pelvis, 2 views | 857 | $25.5K | $29.76 | 2.55x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.1K | $22.5K | $20.53 | 3.20x |
| 73500 | X-ray of hip on one side of body, 1 view | 991 | $19.6K | $19.81 | 3.18x |
| 27137 | Revision of hip joint prosthesis | 13 | $16.0K | $1.2K | 2.37x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 87 | $13.1K | $150.43 | 2.11x |
| 27236 | Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement | 12 | $12.3K | $1.0K | 2.31x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 18 | $10.5K | $580.84 | 2.58x |
| 73565 | X-ray of both knees, standing, front to back view | 410 | $9.5K | $23.21 | 4.70x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 51 | $8.6K | $169.37 | 2.30x |
This provider submits charges 2.47 times higher than what Medicare actually pays.
A markup ratio of 2.47x means for every $100 Medicare pays, this provider initially charges $247. 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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