This provider's $5.8M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 12.59x 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 | $8.4K | $376.18 | 22.31x | $8.0K | $685.7K | 5.2K | 3.8K |
| 2015 | $7.1K | $319.85 | 22.07x | $6.7K | $579.6K | 4.9K | 3.7K |
| 2016 | $6.9K | $341.21 | 20.24x | $6.6K | $656.2K | 4.3K | 3.5K |
| 2017 | $5.3K | $299.00 | 17.68x | $5.0K | $651.1K | 4.5K | 3.7K |
| 2018 | $7.9K | $368.59 | 21.41x | $7.5K | $651.4K | 4.3K | 3.6K |
| 2019 | $7.1K | $375.74 | 18.86x | $6.7K | $605.7K | 4.1K | 3.3K |
| 2020 | $1.5K | $325.84 | 4.61x | $1.2K | $403.3K | 2.9K | 2.4K |
| 2021 | $1.0K | $270.67 | 3.70x | $731.39 | $520.5K | 3.5K | 3.0K |
| 2022 | $1.6K | $279.76 | 5.63x | $1.3K | $488.6K | 3.5K | 3.0K |
| 2023 | $1.5K | $322.02 | 4.55x | $1.1K | $566.7K | 3.7K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.2K | $1.6M | $1.3K | 15.81x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.1K | $1.3M | $1.2K | 21.09x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.8K | $615.0K | $90.05 | 3.12x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.4K | $317.8K | $134.33 | 3.66x |
| 93970 | Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers | 1.9K | $278.4K | $145.47 | 10.66x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 133 | $204.3K | $1.5K | 15.34x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 3.5K | $202.3K | $57.63 | 7.30x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 286 | $192.4K | $672.88 | 2.50x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.7K | $142.8K | $85.95 | 3.73x |
| 73562 | X-ray of knee, 3 views | 4.5K | $142.6K | $31.97 | 5.79x |
| 73564 | X-ray of knee, 4 or more views | 3.5K | $137.8K | $39.17 | 5.24x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.9K | $135.7K | $70.38 | 3.63x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 87 | $135.5K | $1.6K | 32.22x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 3.5K | $131.8K | $37.83 | 6.43x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.7K | $41.2K | $23.94 | 6.73x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 52 | $36.9K | $710.42 | 1.66x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 244 | $31.3K | $128.29 | 5.34x |
| 73500 | X-ray of hip on one side of body, 1 view | 1.3K | $28.8K | $21.66 | 7.84x |
| 73501 | X-ray of hip with pelvis, 1 view | 948 | $26.9K | $28.35 | 3.72x |
| 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 245 | $25.9K | $105.55 | 11.75x |
This provider submits charges 12.59 times higher than what Medicare actually pays.
A markup ratio of 12.59x means for every $100 Medicare pays, this provider initially charges $1259. 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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