This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 6.4x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 102% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 80% in 2019
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 | $324.75 | $68.21 | 4.76x | $256.54 | $219.0K | 3.3K | 1.6K |
| 2015 | $317.63 | $64.93 | 4.89x | $252.70 | $249.9K | 3.4K | 1.8K |
| 2016 | $381.97 | $59.12 | 6.46x | $322.85 | $252.8K | 3.5K | 2.0K |
| 2017 | $371.55 | $55.31 | 6.72x | $316.24 | $300.1K | 4.2K | 2.5K |
| 2018 | $364.48 | $55.03 | 6.62x | $309.45 | $294.5K | 4.2K | 2.4K |
| 2019 | $515.98 | $128.74 | 4.01x | $387.24 | $531.2K | 4.9K | 2.7K |
| 2020 | $449.65 | $90.48 | 4.97x | $359.17 | $288.2K | 4.3K | 2.5K |
| 2021 | $402.40 | $89.87 | 4.48x | $312.53 | $443.4K | 6.0K | 3.4K |
| 2022 | $391.44 | $79.35 | 4.93x | $312.09 | $440.5K | 6.4K | 3.4K |
| 2023 | $335.24 | $49.85 | 6.72x | $285.39 | $441.8K | 7.0K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 10.8K | $1.1M | $106.67 | 7.16x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.0K | $480.3K | $68.50 | 4.22x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 2.8K | $447.7K | $158.18 | 4.32x |
| 76881 | Ultrasound of leg or arm | 4.5K | $282.6K | $63.33 | 11.05x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.2K | $219.4K | $100.90 | 4.41x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $181.5K | $134.57 | 4.98x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 112 | $101.9K | $909.53 | 2.04x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.1K | $95.3K | $86.06 | 5.23x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 1.4K | $83.8K | $58.97 | 9.10x |
| 73562 | X-ray of knee, 3 views | 1.6K | $71.4K | $44.24 | 6.51x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 49 | $56.0K | $1.1K | 1.66x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 944 | $49.0K | $51.93 | 5.81x |
| J7322 | Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg | 1.5K | $34.0K | $23.35 | 37.47x |
| 73522 | X-ray of both hips with pelvis, 3-4 views | 537 | $25.8K | $48.02 | 6.25x |
| 73030 | X-ray of shoulder, minimum of 2 views | 759 | $23.4K | $30.79 | 5.91x |
| J3304 | Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg | 1.5K | $21.0K | $13.75 | 7.59x |
| 73010 | X-ray of shoulder blade | 726 | $19.1K | $26.30 | 6.56x |
| 20551 | Injections of tendon attachment to bone | 347 | $17.8K | $51.26 | 6.81x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 134 | $9.2K | $68.83 | 6.54x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 260 | $9.1K | $35.08 | 6.41x |
This provider submits charges 6.4 times higher than what Medicare actually pays.
A markup ratio of 6.4x means for every $100 Medicare pays, this provider initially charges $640. 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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