This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.45x 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 | $2.8K | $444.57 | 6.32x | $2.4K | $404.0K | 1.2K | 1.0K |
| 2015 | $3.1K | $512.87 | 5.97x | $2.5K | $523.1K | 1.4K | 1.3K |
| 2016 | $2.7K | $485.76 | 5.49x | $2.2K | $424.9K | 1.4K | 1.2K |
| 2017 | $2.4K | $433.91 | 5.48x | $1.9K | $512.9K | 1.6K | 1.3K |
| 2018 | $2.5K | $444.58 | 5.53x | $2.0K | $495.3K | 1.6K | 1.4K |
| 2019 | $2.8K | $530.70 | 5.30x | $2.3K | $476.7K | 1.5K | 1.3K |
| 2020 | $2.6K | $487.21 | 5.40x | $2.1K | $375.0K | 1.3K | 1.1K |
| 2021 | $2.7K | $502.90 | 5.47x | $2.2K | $394.6K | 1.3K | 1.0K |
| 2022 | $2.6K | $473.98 | 5.46x | $2.1K | $360.8K | 1.3K | 1.1K |
| 2023 | $2.4K | $414.77 | 5.71x | $2.0K | $256.0K | 1.0K | 833 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 666 | $894.0K | $1.3K | 4.86x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 403 | $336.3K | $834.58 | 6.86x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.0K | $297.1K | $59.19 | 3.56x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 635 | $292.6K | $460.79 | 8.38x |
| 22214 | Incision of spine to correct deformity at lower spinal column | 342 | $200.4K | $585.93 | 8.94x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 616 | $185.8K | $301.60 | 4.43x |
| 22207 | Incision of spine to correct deformity at lower spinal column | 84 | $161.3K | $1.9K | 4.62x |
| 22844 | Insertion of posterior spinal instrumentation for spinal stabilization, 13 or more vertebral segments | 193 | $152.6K | $790.89 | 4.40x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 275 | $151.6K | $551.45 | 4.44x |
| 22843 | Insertion of posterior spinal instrumentation for spinal stabilization, 7 to 12 vertebral segments | 232 | $144.0K | $620.68 | 4.44x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 893 | $142.1K | $159.16 | 3.65x |
| 22634 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 349 | $134.8K | $386.22 | 4.47x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 187 | $118.5K | $633.89 | 8.66x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 207 | $113.9K | $550.25 | 4.38x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 190 | $108.3K | $570.06 | 4.40x |
| 22216 | Incision of spine bone to correct spinal deformity of spinal column | 373 | $106.4K | $285.26 | 4.44x |
| 22848 | Insertion of instrumentation to pelvic bones | 360 | $102.4K | $284.53 | 4.38x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 494 | $98.2K | $198.70 | 4.61x |
| 22830 | Exploration of spinal fusion | 284 | $95.7K | $337.14 | 8.39x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 452 | $72.7K | $160.84 | 4.37x |
This provider submits charges 5.45 times higher than what Medicare actually pays.
A markup ratio of 5.45x means for every $100 Medicare pays, this provider initially charges $545. 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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