This provider's $3.3M in total Medicare payments ranks in the 98th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 6.33x 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 | $646.46 | $108.18 | 5.98x | $538.28 | $248.7K | 4.9K | 3.4K |
| 2015 | $769.66 | $139.81 | 5.51x | $629.85 | $290.4K | 5.2K | 3.6K |
| 2016 | $838.63 | $146.06 | 5.74x | $692.57 | $333.0K | 5.6K | 4.0K |
| 2017 | $908.43 | $150.86 | 6.02x | $757.57 | $366.0K | 5.9K | 4.0K |
| 2018 | $1.0K | $151.91 | 6.61x | $851.88 | $341.8K | 5.8K | 4.0K |
| 2019 | $920.08 | $135.42 | 6.79x | $784.66 | $335.3K | 5.6K | 3.9K |
| 2020 | $999.57 | $139.86 | 7.15x | $859.71 | $288.3K | 5.0K | 3.3K |
| 2021 | $1.1K | $163.87 | 6.71x | $936.19 | $352.5K | 4.9K | 3.4K |
| 2022 | $1.2K | $161.45 | 7.16x | $995.24 | $379.4K | 4.8K | 3.5K |
| 2023 | $1.0K | $132.00 | 7.65x | $878.22 | $371.1K | 5.1K | 3.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 856 | $917.9K | $1.1K | 7.84x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 10.7K | $552.5K | $51.43 | 7.49x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 362 | $384.4K | $1.1K | 7.21x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.8K | $264.7K | $54.91 | 2.54x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 3.9K | $129.9K | $33.08 | 3.23x |
| 73564 | X-ray of knee, 4 or more views | 4.1K | $112.9K | $27.70 | 6.39x |
| 27245 | Surgical treatment of broken thigh bone | 103 | $102.0K | $990.53 | 5.44x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.3K | $100.2K | $76.83 | 2.47x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 102 | $97.3K | $954.29 | 5.17x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 747 | $89.1K | $119.22 | 5.73x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 950 | $70.8K | $74.48 | 2.86x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.0K | $56.2K | $28.09 | 6.28x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 7.6K | $55.3K | $7.33 | 3.69x |
| 77085 | Bone density measurement using dedicated X-ray machine | 1.0K | $46.2K | $44.49 | 8.11x |
| 73562 | X-ray of knee, 3 views | 1.7K | $42.7K | $24.40 | 6.51x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 794 | $38.8K | $48.90 | 2.87x |
| 73721 | MRI scan of leg joint | 430 | $34.3K | $79.73 | 13.08x |
| J3304 | Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg | 2.1K | $29.3K | $14.03 | 1.87x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 474 | $25.6K | $54.04 | 3.86x |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 1.7K | $15.4K | $9.27 | 2.02x |
This provider submits charges 6.33 times higher than what Medicare actually pays.
A markup ratio of 6.33x means for every $100 Medicare pays, this provider initially charges $633. 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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