This provider's $5.3M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 7.88x 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 | $2.2K | $276.32 | 7.99x | $1.9K | $536.2K | 3.2K | 2.7K |
| 2015 | $2.3K | $296.57 | 7.72x | $2.0K | $602.0K | 3.5K | 3.0K |
| 2016 | $2.3K | $276.46 | 8.36x | $2.0K | $596.7K | 3.7K | 3.2K |
| 2017 | $2.1K | $270.37 | 7.94x | $1.9K | $511.0K | 3.1K | 2.6K |
| 2018 | $2.4K | $314.44 | 7.58x | $2.1K | $545.2K | 3.2K | 2.6K |
| 2019 | $2.3K | $290.14 | 7.82x | $2.0K | $514.7K | 3.1K | 2.6K |
| 2020 | $2.4K | $306.79 | 7.71x | $2.1K | $524.7K | 3.1K | 2.6K |
| 2021 | $2.3K | $287.86 | 7.95x | $2.0K | $527.2K | 3.2K | 2.7K |
| 2022 | $2.2K | $283.48 | 7.80x | $1.9K | $492.7K | 3.1K | 2.6K |
| 2023 | $2.3K | $262.49 | 8.74x | $2.0K | $422.9K | 2.7K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 578 | $799.3K | $1.4K | 6.56x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 517 | $579.3K | $1.1K | 6.79x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 623 | $385.4K | $618.57 | 12.03x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 659 | $379.0K | $575.06 | 11.13x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.8K | $358.0K | $52.64 | 3.49x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 286 | $353.6K | $1.2K | 6.88x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 546 | $268.8K | $492.35 | 11.94x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 463 | $256.6K | $554.28 | 8.83x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 921 | $178.3K | $193.62 | 4.91x |
| 20937 | Harvest of bone fragments for spine surgery graft | 1.4K | $178.2K | $126.77 | 13.44x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 324 | $175.0K | $540.26 | 10.31x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 464 | $139.9K | $301.52 | 6.51x |
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 1.3K | $122.5K | $95.95 | 8.34x |
| 72148 | MRI scan of lower spinal canal | 1.3K | $121.2K | $92.65 | 12.79x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 420 | $120.4K | $286.61 | 4.94x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 5.0K | $118.9K | $23.90 | 5.19x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.6K | $113.6K | $70.62 | 3.49x |
| 22585 | Fusion of spine bones with removal of disc, anterior approach | 302 | $72.4K | $239.85 | 6.64x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 1.9K | $59.0K | $31.84 | 5.72x |
| 22552 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 196 | $58.1K | $296.61 | 6.62x |
This provider submits charges 7.88 times higher than what Medicare actually pays.
A markup ratio of 7.88x means for every $100 Medicare pays, this provider initially charges $788. 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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