This provider's $4.6M 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 | $785.53 | $191.91 | 4.09x | $593.62 | $461.2K | 6.9K | 4.9K |
| 2015 | $722.48 | $187.54 | 3.85x | $534.94 | $470.6K | 7.4K | 5.3K |
| 2016 | $744.47 | $173.00 | 4.30x | $571.47 | $496.6K | 6.8K | 5.0K |
| 2017 | $768.90 | $162.24 | 4.74x | $606.66 | $491.9K | 7.2K | 5.3K |
| 2018 | $910.61 | $170.57 | 5.34x | $740.04 | $524.8K | 7.6K | 5.5K |
| 2019 | $1.1K | $149.91 | 7.08x | $911.40 | $511.0K | 7.6K | 5.5K |
| 2020 | $1.0K | $144.58 | 7.10x | $882.20 | $458.0K | 7.3K | 5.4K |
| 2021 | $1.1K | $138.51 | 7.74x | $933.92 | $440.7K | 6.5K | 4.9K |
| 2022 | $1.1K | $145.39 | 7.84x | $994.21 | $382.8K | 6.1K | 4.5K |
| 2023 | $934.52 | $106.70 | 8.76x | $827.82 | $341.3K | 6.0K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 717 | $793.7K | $1.1K | 6.37x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 11.5K | $624.4K | $54.40 | 4.75x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.8K | $587.7K | $86.10 | 1.94x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.9K | $564.7K | $57.02 | 2.12x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 317 | $354.6K | $1.1K | 5.11x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.6K | $203.8K | $79.29 | 2.12x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 1.6K | $183.8K | $114.60 | 2.36x |
| 73562 | X-ray of knee, 3 views | 6.1K | $180.8K | $29.77 | 5.27x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 1.9K | $150.1K | $77.67 | 3.29x |
| 29881 | Removal of one knee cartilage using an endoscope | 336 | $142.0K | $422.61 | 10.11x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 1.9K | $128.3K | $66.78 | 3.42x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 3.5K | $124.7K | $35.24 | 2.19x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.8K | $92.6K | $33.67 | 3.90x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 776 | $92.4K | $119.10 | 2.21x |
| 73560 | X-ray of knee, 1 or 2 views | 3.8K | $90.8K | $23.97 | 2.91x |
| 73565 | X-ray of both knees, standing, front to back view | 1.7K | $46.7K | $27.18 | 2.23x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 6.8K | $28.6K | $4.22 | 5.40x |
| 27446 | Repair of knee joint | 27 | $25.6K | $946.85 | 3.17x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 816 | $24.0K | $29.45 | 1.94x |
| 29880 | Removal of both knee cartilages using an endoscope | 48 | $21.3K | $444.34 | 6.79x |
This provider submits charges 4.05 times higher than what Medicare actually pays.
A markup ratio of 4.05x means for every $100 Medicare pays, this provider initially charges $405. 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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