This provider's $5.3M in total Medicare payments ranks in the 94th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 6.91x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 128% from 2021 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 71% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2021 | $18.7K | $2.5K | 7.52x | $16.2K | $1.1M | 312 | 301 |
| 2022 | $16.6K | $2.4K | 6.92x | $14.2K | $1.8M | 468 | 451 |
| 2023 | $18.5K | $2.8K | 6.68x | $15.7K | $2.4M | 541 | 522 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27130 | Replacement of thigh bone and hip joint prosthesis | 303 | $2.2M | $7.3K | 6.70x |
| 27447 | Repair of knee joint, lower or upper part of joint, inside and outside area | 284 | $2.1M | $7.3K | 7.31x |
| 27446 | Repair of knee joint, lower or upper part of joint, inside or outside area | 116 | $821.9K | $7.1K | 6.17x |
| 20902 | Bone graft harvest | 46 | $55.8K | $1.2K | 7.69x |
| 28750 | Fusion of big toe at joint with foot | 12 | $39.8K | $3.3K | 2.71x |
| 20680 | Removal of deep bone implant | 45 | $37.1K | $824.59 | 8.76x |
| 64721 | Release and/or relocation of median nerve of hand | 47 | $28.3K | $601.62 | 10.59x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 14 | $26.4K | $1.9K | 9.13x |
| 28308 | Incision to straighten toe bone (other than the big toe) at the midfoot bone (metatarsal) level | 25 | $16.3K | $650.71 | 10.76x |
| 28285 | Correction of toe joint deformity | 23 | $13.6K | $592.64 | 5.35x |
| 26055 | Incision of tendon covering | 25 | $12.5K | $498.78 | 13.03x |
| 76000 | Imaging guidance for procedure, up to 1 hour | 69 | $1.5K | $22.24 | 10.97x |
| C9290 | Injection, bupivacaine liposome, 1 mg | 312 | $334.93 | $1.07 | 1.38x |
This provider submits charges 6.91 times higher than what Medicare actually pays.
A markup ratio of 6.91x means for every $100 Medicare pays, this provider initially charges $691. 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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