This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 6.22x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 177% from 2014 to 2023.
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 | $1.2K | $157.25 | 7.37x | $1.0K | $231.8K | 1.8K | 1.4K |
| 2015 | $945.27 | $153.54 | 6.16x | $791.73 | $297.0K | 2.3K | 1.7K |
| 2016 | $1.5K | $238.01 | 6.35x | $1.3K | $325.0K | 2.4K | 1.7K |
| 2017 | $997.67 | $146.62 | 6.80x | $851.05 | $318.4K | 2.4K | 1.7K |
| 2018 | $972.40 | $155.04 | 6.27x | $817.36 | $386.1K | 2.6K | 1.9K |
| 2019 | $1.5K | $273.01 | 5.36x | $1.2K | $409.2K | 2.4K | 1.9K |
| 2020 | $1.2K | $252.13 | 4.84x | $967.34 | $385.2K | 2.4K | 1.9K |
| 2021 | $1.4K | $285.53 | 4.77x | $1.1K | $506.6K | 2.8K | 2.3K |
| 2022 | $1.0K | $191.71 | 5.35x | $834.78 | $572.1K | 3.2K | 2.6K |
| 2023 | $1.6K | $249.95 | 6.41x | $1.4K | $642.6K | 3.7K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.5K | $1.3M | $857.17 | 7.45x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 925 | $983.7K | $1.1K | 6.26x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 456 | $294.3K | $645.41 | 2.83x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.8K | $276.4K | $99.98 | 5.59x |
| 73562 | X-ray of knee, 3 views | 5.1K | $220.1K | $42.94 | 5.42x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.2K | $219.8K | $67.77 | 6.01x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $156.9K | $143.54 | 5.64x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.0K | $130.0K | $63.68 | 7.27x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.8K | $114.1K | $40.54 | 5.64x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 784 | $72.9K | $93.01 | 5.78x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 54 | $72.8K | $1.3K | 6.08x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 28 | $46.6K | $1.7K | 5.63x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 261 | $38.5K | $147.52 | 5.27x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 579 | $26.7K | $46.12 | 5.43x |
| 73630 | X-ray of foot, minimum of 3 views | 685 | $21.6K | $31.48 | 6.08x |
| 73610 | X-ray of ankle, minimum of 3 views | 502 | $16.8K | $33.50 | 5.50x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 131 | $15.9K | $121.60 | 3.84x |
| 72170 | X-ray of pelvis, 1 or 2 views | 495 | $12.8K | $25.77 | 6.24x |
| 73521 | X-ray of both hips with pelvis, 2 views | 223 | $8.3K | $37.03 | 5.91x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 39 | $7.7K | $196.33 | 5.56x |
This provider submits charges 6.22 times higher than what Medicare actually pays.
A markup ratio of 6.22x means for every $100 Medicare pays, this provider initially charges $622. 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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