This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 6.66x is significantly above the specialty median of 4.7x.
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 | $2.0K | $332.15 | 6.10x | $1.7K | $488.6K | 2.1K | 1.9K |
| 2015 | $2.2K | $399.50 | 5.52x | $1.8K | $492.2K | 2.1K | 1.9K |
| 2016 | $2.3K | $416.91 | 5.49x | $1.9K | $427.9K | 2.1K | 1.8K |
| 2017 | $2.1K | $387.63 | 5.46x | $1.7K | $401.6K | 2.1K | 1.7K |
| 2018 | $1.8K | $313.22 | 5.65x | $1.5K | $419.1K | 2.0K | 1.6K |
| 2019 | $2.3K | $316.74 | 7.26x | $2.0K | $374.2K | 1.6K | 1.4K |
| 2020 | $3.3K | $351.51 | 9.48x | $3.0K | $290.3K | 1.1K | 948 |
| 2021 | $4.4K | $499.88 | 8.85x | $3.9K | $266.9K | 924 | 806 |
| 2022 | $3.7K | $437.29 | 8.54x | $3.3K | $202.6K | 740 | 644 |
| 2023 | $4.2K | $402.23 | 10.41x | $3.8K | $248.4K | 964 | 789 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 642 | $1.0M | $1.6K | 6.86x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 924 | $435.4K | $471.23 | 10.65x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 592 | $383.7K | $648.09 | 5.40x |
| 22630 | Fusion of lower spine bones with removal of disc, posterior approach | 238 | $301.0K | $1.3K | 5.50x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.8K | $275.0K | $57.31 | 4.31x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 305 | $199.8K | $655.10 | 5.56x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 905 | $164.1K | $181.30 | 8.12x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $137.7K | $122.34 | 4.77x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 599 | $132.6K | $221.33 | 5.81x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 363 | $124.8K | $343.75 | 4.82x |
| 22634 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 191 | $81.1K | $424.39 | 9.08x |
| 22830 | Exploration of spinal fusion | 174 | $64.4K | $370.36 | 9.99x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.5K | $49.1K | $32.38 | 4.44x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 34 | $45.3K | $1.3K | 7.25x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.5K | $37.7K | $25.87 | 5.99x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 33 | $36.4K | $1.1K | 5.91x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 405 | $34.6K | $85.37 | 4.34x |
| 22632 | Fusion of lower spine bones with removal of disc, posterior approach | 116 | $31.6K | $272.65 | 5.39x |
| 20931 | Donor bone graft for spine surgery | 234 | $22.4K | $95.64 | 4.75x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 354 | $14.8K | $41.93 | 5.41x |
This provider submits charges 6.66 times higher than what Medicare actually pays.
A markup ratio of 6.66x means for every $100 Medicare pays, this provider initially charges $666. 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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