This provider's $5.8M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.77x 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 | $1.3K | $148.96 | 9.03x | $1.2K | $583.9K | 8.2K | 5.6K |
| 2015 | $1.5K | $177.08 | 8.33x | $1.3K | $650.4K | 9.6K | 6.3K |
| 2016 | $1.3K | $151.14 | 8.55x | $1.1K | $649.3K | 9.5K | 6.2K |
| 2017 | $1.3K | $149.27 | 8.62x | $1.1K | $655.0K | 9.8K | 6.5K |
| 2018 | $1.2K | $147.49 | 8.15x | $1.1K | $648.7K | 10.2K | 6.8K |
| 2019 | $993.56 | $173.25 | 5.73x | $820.31 | $624.2K | 9.4K | 6.3K |
| 2020 | $883.14 | $160.79 | 5.49x | $722.35 | $502.9K | 6.8K | 4.7K |
| 2021 | $1.2K | $163.38 | 7.36x | $1.0K | $547.3K | 7.6K | 5.1K |
| 2022 | $988.07 | $143.11 | 6.90x | $844.96 | $483.9K | 7.0K | 4.7K |
| 2023 | $1.1K | $158.81 | 7.18x | $980.92 | $459.9K | 6.7K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.3K | $1.5M | $1.1K | 8.53x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 19.5K | $1.0M | $53.40 | 5.49x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.6K | $664.2K | $57.19 | 2.38x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 485 | $536.4K | $1.1K | 7.02x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 3.3K | $380.2K | $115.09 | 2.54x |
| 73562 | X-ray of knee, 3 views | 9.9K | $280.5K | $28.34 | 6.73x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 6.7K | $233.2K | $34.70 | 2.77x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.7K | $214.8K | $78.46 | 2.35x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 225 | $194.4K | $863.91 | 1.62x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 1.4K | $94.9K | $66.25 | 3.61x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.6K | $86.7K | $33.00 | 4.98x |
| 29880 | Removal of both knee cartilages using an endoscope | 173 | $79.8K | $461.43 | 17.34x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 929 | $77.1K | $82.94 | 2.08x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 871 | $45.4K | $52.17 | 2.86x |
| 29881 | Removal of one knee cartilage using an endoscope | 91 | $40.3K | $442.53 | 16.50x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.7K | $39.7K | $23.11 | 7.53x |
| 64721 | Release and/or relocation of median nerve of hand | 112 | $37.1K | $331.10 | 6.50x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 34 | $30.0K | $881.33 | 2.10x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 200 | $24.8K | $123.89 | 2.14x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 40 | $21.2K | $530.67 | 5.08x |
This provider submits charges 5.77 times higher than what Medicare actually pays.
A markup ratio of 5.77x means for every $100 Medicare pays, this provider initially charges $577. 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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