This provider's $5.9M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 483% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 93% in 2015
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $764.66 | $183.02 | 4.18x | $581.64 | $152.8K | 2.1K | 1.2K |
| 2015 | $1.2K | $264.99 | 4.41x | $902.60 | $295.0K | 2.7K | 1.5K |
| 2016 | $1.4K | $310.59 | 4.49x | $1.1K | $451.7K | 3.4K | 1.9K |
| 2017 | $1.5K | $306.11 | 4.74x | $1.1K | $579.3K | 4.0K | 2.5K |
| 2018 | $1.5K | $328.53 | 4.55x | $1.2K | $581.9K | 4.2K | 2.5K |
| 2019 | $1.5K | $321.43 | 4.62x | $1.2K | $614.2K | 4.3K | 2.5K |
| 2020 | $1.5K | $327.43 | 4.58x | $1.2K | $605.8K | 3.4K | 2.4K |
| 2021 | $1.7K | $375.57 | 4.50x | $1.3K | $870.4K | 4.4K | 3.1K |
| 2022 | $1.7K | $364.50 | 4.54x | $1.3K | $818.0K | 4.9K | 3.5K |
| 2023 | $1.4K | $303.84 | 4.57x | $1.1K | $890.7K | 6.3K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.2K | $603.9K | $97.77 | 3.17x |
| 63090 | Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach | 316 | $463.0K | $1.5K | 3.91x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 448 | $430.2K | $960.22 | 4.72x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 694 | $420.1K | $605.30 | 3.57x |
| 22214 | Incision of spine to correct deformity at lower spinal column | 539 | $340.4K | $631.62 | 6.57x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.8K | $265.4K | $70.33 | 2.94x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 425 | $263.9K | $621.04 | 3.65x |
| 63081 | Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach | 161 | $222.9K | $1.4K | 3.62x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 354 | $206.9K | $584.56 | 7.56x |
| 22216 | Incision of spine bone to correct spinal deformity of spinal column | 679 | $197.4K | $290.75 | 3.54x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $191.4K | $138.92 | 3.43x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 303 | $182.4K | $602.09 | 4.32x |
| 22802 | Fusion of spine bones for correction of deformity, posterior approach, 7 to 12 vertebral segments | 118 | $179.2K | $1.5K | 3.74x |
| 72148 | MRI scan of lower spinal canal | 1.1K | $136.2K | $121.95 | 9.99x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 390 | $121.7K | $312.05 | 3.57x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 558 | $118.5K | $212.43 | 3.63x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 4.3K | $98.6K | $22.83 | 3.66x |
| 63042 | Re-exploration of spine repair with release of lower spinal cord or nerves | 78 | $88.0K | $1.1K | 4.66x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 1.9K | $87.6K | $45.06 | 3.93x |
| 22843 | Insertion of posterior spinal instrumentation for spinal stabilization, 7 to 12 vertebral segments | 143 | $87.0K | $608.55 | 4.05x |
This provider submits charges 4.35 times higher than what Medicare actually pays.
A markup ratio of 4.35x means for every $100 Medicare pays, this provider initially charges $435. 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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