This provider's $4.7M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.74x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 151% from 2014 to 2023.
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 | $1.7K | $186.71 | 9.02x | $1.5K | $262.9K | 2.7K | 1.8K |
| 2015 | $1.3K | $182.06 | 7.06x | $1.1K | $257.8K | 2.6K | 1.8K |
| 2016 | $1.2K | $167.27 | 6.91x | $987.85 | $323.0K | 3.6K | 2.4K |
| 2017 | $1.1K | $184.34 | 6.08x | $936.70 | $351.3K | 4.0K | 2.6K |
| 2018 | $1.6K | $274.77 | 5.78x | $1.3K | $449.0K | 4.8K | 3.0K |
| 2019 | $1.5K | $264.44 | 5.62x | $1.2K | $502.1K | 5.5K | 3.4K |
| 2020 | $907.68 | $157.83 | 5.75x | $749.85 | $470.2K | 5.1K | 3.1K |
| 2021 | $1.3K | $276.26 | 4.61x | $996.13 | $657.0K | 6.3K | 3.9K |
| 2022 | $1.5K | $299.77 | 5.15x | $1.2K | $739.8K | 7.1K | 3.9K |
| 2023 | $1.2K | $188.37 | 6.56x | $1.0K | $660.8K | 7.3K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 979 | $1.3M | $1.4K | 6.55x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 6.2K | $683.3K | $110.02 | 3.97x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 9.4K | $658.5K | $69.90 | 7.14x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.0K | $421.6K | $70.12 | 5.81x |
| 73564 | X-ray of knee, 4 or more views | 6.5K | $341.5K | $52.15 | 5.26x |
| 73562 | X-ray of knee, 3 views | 6.6K | $269.8K | $40.99 | 5.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.8K | $250.4K | $142.35 | 5.06x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.5K | $238.8K | $96.25 | 4.93x |
| 73560 | X-ray of knee, 1 or 2 views | 4.0K | $119.1K | $29.47 | 5.21x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 52 | $92.2K | $1.8K | 5.16x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 896 | $82.9K | $92.56 | 5.27x |
| 29881 | Removal of one knee cartilage using an endoscope | 108 | $56.9K | $526.60 | 7.65x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 314 | $48.0K | $152.75 | 5.32x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 53 | $34.9K | $658.27 | 2.79x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 2.0K | $9.9K | $4.96 | 4.24x |
| 99212 | Established patient outpatient visit, total time 10-19 minutes | 205 | $8.7K | $42.41 | 4.69x |
| 29880 | Removal of both knee cartilages using an endoscope | 13 | $7.0K | $536.43 | 10.04x |
| 72170 | X-ray of pelvis, 1 or 2 views | 215 | $6.0K | $27.85 | 4.90x |
| G0180 | Physician or allowed practitioner 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 and | 96 | $4.6K | $48.09 | 8.63x |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 382 | $3.6K | $9.48 | 2.81x |
This provider submits charges 5.74 times higher than what Medicare actually pays.
A markup ratio of 5.74x means for every $100 Medicare pays, this provider initially charges $574. 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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