This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 6.99x 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 | $1.5K | $161.64 | 9.34x | $1.3K | $384.2K | 4.3K | 3.0K |
| 2015 | $2.0K | $203.88 | 9.86x | $1.8K | $389.1K | 4.2K | 2.9K |
| 2016 | $1.4K | $149.50 | 9.46x | $1.3K | $409.8K | 4.6K | 3.3K |
| 2017 | $1.4K | $145.00 | 9.95x | $1.3K | $379.9K | 4.6K | 3.4K |
| 2018 | $1.3K | $147.16 | 9.14x | $1.2K | $460.1K | 4.7K | 3.4K |
| 2019 | $858.35 | $162.71 | 5.28x | $695.64 | $529.0K | 5.0K | 3.5K |
| 2020 | $759.26 | $165.85 | 4.58x | $593.41 | $380.3K | 3.8K | 2.7K |
| 2021 | $987.27 | $156.19 | 6.32x | $831.08 | $512.9K | 4.5K | 3.2K |
| 2022 | $1.9K | $147.96 | 12.83x | $1.7K | $492.7K | 4.6K | 3.0K |
| 2023 | $2.3K | $180.76 | 12.93x | $2.2K | $464.8K | 4.4K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 702 | $916.9K | $1.3K | 11.78x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 434 | $555.6K | $1.3K | 11.81x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.4K | $522.4K | $96.86 | 4.17x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.2K | $495.1K | $68.97 | 4.26x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 3.0K | $306.0K | $103.13 | 5.28x |
| 73562 | X-ray of knee, 3 views | 6.8K | $260.9K | $38.40 | 4.07x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.6K | $230.3K | $141.39 | 4.33x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.7K | $148.2K | $54.30 | 3.94x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.1K | $108.3K | $94.29 | 4.55x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 1.6K | $105.2K | $64.64 | 4.68x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 903 | $99.9K | $110.64 | 2.40x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.3K | $88.5K | $39.17 | 4.22x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 602 | $87.2K | $144.85 | 4.00x |
| 73721 | MRI scan of leg joint | 508 | $80.8K | $158.97 | 8.37x |
| 72148 | MRI scan of lower spinal canal | 539 | $76.8K | $142.44 | 9.59x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.4K | $47.5K | $33.06 | 4.36x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.2K | $33.9K | $27.43 | 4.72x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 91 | $28.1K | $308.67 | 1.56x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 601 | $27.9K | $46.49 | 4.29x |
| 73221 | MRI scan of arm joint | 128 | $20.5K | $160.02 | 7.96x |
This provider submits charges 6.99 times higher than what Medicare actually pays.
A markup ratio of 6.99x means for every $100 Medicare pays, this provider initially charges $699. 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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