This provider's $6.9M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $360.42 | 3.37x | $855.49 | $630.0K | 2.2K | 1.9K |
| 2015 | $1.4K | $407.16 | 3.41x | $980.46 | $768.3K | 2.6K | 2.3K |
| 2016 | $1.3K | $377.27 | 3.46x | $927.86 | $719.7K | 2.3K | 2.2K |
| 2017 | $1.3K | $385.73 | 3.32x | $896.34 | $854.7K | 2.5K | 2.4K |
| 2018 | $1.3K | $392.51 | 3.28x | $896.51 | $699.8K | 2.0K | 1.9K |
| 2019 | $1.2K | $384.15 | 3.18x | $835.86 | $649.4K | 1.9K | 1.8K |
| 2020 | $1.2K | $401.33 | 2.95x | $781.79 | $593.6K | 1.8K | 1.6K |
| 2021 | $1.4K | $481.88 | 2.93x | $930.03 | $608.4K | 1.9K | 1.8K |
| 2022 | $1.3K | $423.08 | 3.11x | $891.38 | $688.1K | 2.1K | 2.0K |
| 2023 | $1.3K | $408.81 | 3.07x | $847.10 | $648.0K | 1.9K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 737 | $791.7K | $1.1K | 3.33x |
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 479 | $777.1K | $1.6K | 2.62x |
| 63042 | Re-exploration of spine repair with release of lower spinal cord or nerves | 502 | $711.1K | $1.4K | 3.54x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 743 | $498.9K | $671.42 | 2.57x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 710 | $492.0K | $693.00 | 3.60x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 608 | $407.7K | $670.48 | 5.13x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 427 | $284.6K | $666.56 | 2.59x |
| 63081 | Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach | 152 | $229.3K | $1.5K | 2.62x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 964 | $220.0K | $228.20 | 2.58x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.9K | $188.5K | $64.11 | 2.82x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.8K | $180.7K | $100.84 | 2.83x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 450 | $153.6K | $341.27 | 2.57x |
| 63044 | Re-exploration of spine repair with release of lower spinal cord or nerves | 277 | $153.2K | $553.08 | 3.39x |
| 22214 | Incision of spine to correct deformity at lower spinal column | 194 | $130.6K | $673.05 | 5.03x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 367 | $128.4K | $349.98 | 2.56x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 198 | $127.7K | $644.82 | 2.56x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach, complex | 86 | $124.6K | $1.4K | 2.71x |
| 22856 | Insertion of artificial upper spine disc, anterior approach | 93 | $124.3K | $1.3K | 2.80x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 534 | $99.1K | $185.57 | 2.57x |
| 22830 | Exploration of spinal fusion | 250 | $91.7K | $366.75 | 5.10x |
This provider submits charges 3.18 times higher than what Medicare actually pays.
A markup ratio of 3.18x means for every $100 Medicare pays, this provider initially charges $318. 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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