This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 91% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 61% in 2019
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $663.34 | $143.77 | 4.61x | $519.57 | $227.9K | 3.5K | 2.7K |
| 2015 | $640.90 | $148.75 | 4.31x | $492.15 | $274.5K | 4.2K | 3.2K |
| 2016 | $602.85 | $142.18 | 4.24x | $460.67 | $335.3K | 4.8K | 3.6K |
| 2017 | $573.32 | $143.39 | 4.00x | $429.93 | $390.0K | 5.3K | 4.1K |
| 2018 | $682.04 | $120.92 | 5.64x | $561.12 | $513.1K | 8.2K | 6.3K |
| 2019 | $742.93 | $104.91 | 7.08x | $638.02 | $825.7K | 14.8K | 9.3K |
| 2020 | $1.0K | $144.89 | 7.24x | $903.86 | $447.3K | 6.7K | 5.2K |
| 2021 | $1.1K | $144.61 | 7.62x | $957.47 | $447.3K | 6.1K | 4.9K |
| 2022 | $1.3K | $179.17 | 7.52x | $1.2K | $493.6K | 6.2K | 5.0K |
| 2023 | $1.2K | $144.72 | 8.02x | $1.0K | $435.2K | 5.8K | 4.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 18.2K | $1.1M | $60.01 | 2.07x |
| 23472 | Prosthetic repair of shoulder joint | 462 | $551.9K | $1.2K | 4.12x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.0K | $524.4K | $87.17 | 1.93x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 392 | $337.8K | $861.71 | 5.07x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 4.2K | $320.8K | $76.85 | 3.26x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.4K | $274.4K | $80.11 | 2.13x |
| 73030 | X-ray of shoulder, minimum of 2 views | 10.3K | $255.9K | $24.75 | 5.10x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 3.7K | $203.3K | $54.88 | 5.19x |
| 23430 | Anchoring of biceps tendon | 459 | $143.0K | $311.61 | 8.78x |
| 29823 | Extensive removal of shoulder joint tissue using an endoscope | 493 | $128.7K | $261.07 | 15.62x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 802 | $98.8K | $123.13 | 2.15x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 722 | $81.1K | $112.27 | 2.40x |
| 29826 | Shaving of shoulder bone using an endoscope | 519 | $74.7K | $143.86 | 26.02x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.3K | $53.2K | $39.55 | 2.28x |
| 72040 | X-ray of spine of neck, 2 or 3 views | 1.4K | $40.8K | $28.64 | 4.38x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 6.0K | $27.2K | $4.52 | 5.28x |
| 73070 | X-ray of elbow, 2 views | 1.2K | $26.9K | $21.84 | 4.34x |
| 73562 | X-ray of knee, 3 views | 627 | $18.2K | $29.05 | 5.79x |
| 27236 | Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement | 15 | $14.8K | $984.15 | 7.40x |
| 20605 | Aspiration and/or injection of medium joint or joint capsule | 372 | $14.5K | $39.04 | 5.10x |
This provider submits charges 4.15 times higher than what Medicare actually pays.
A markup ratio of 4.15x means for every $100 Medicare pays, this provider initially charges $415. 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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