This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.23x 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 | $1.4K | $298.60 | 4.61x | $1.1K | $435.8K | 2.7K | 2.1K |
| 2015 | $1.5K | $333.32 | 4.39x | $1.1K | $385.2K | 2.4K | 1.9K |
| 2016 | $1.3K | $292.20 | 4.45x | $1.0K | $380.4K | 2.4K | 1.9K |
| 2017 | $1.5K | $336.18 | 4.49x | $1.2K | $383.5K | 2.4K | 1.8K |
| 2018 | $1.6K | $333.05 | 4.93x | $1.3K | $367.4K | 2.2K | 1.7K |
| 2019 | $1.8K | $335.10 | 5.46x | $1.5K | $383.2K | 2.1K | 1.7K |
| 2020 | $2.0K | $356.36 | 5.67x | $1.7K | $430.3K | 2.1K | 1.7K |
| 2021 | $2.0K | $329.99 | 6.07x | $1.7K | $360.9K | 2.1K | 1.7K |
| 2022 | $1.8K | $295.35 | 6.12x | $1.5K | $368.1K | 2.0K | 1.6K |
| 2023 | $1.5K | $232.90 | 6.63x | $1.3K | $357.4K | 2.0K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 795 | $1.2M | $1.5K | 5.31x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 705 | $331.1K | $469.58 | 8.80x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 474 | $289.9K | $611.61 | 4.34x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 415 | $251.6K | $606.26 | 5.76x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.3K | $171.3K | $51.20 | 2.80x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 461 | $145.7K | $316.15 | 3.78x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.6K | $128.1K | $80.01 | 2.97x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 621 | $128.1K | $206.25 | 4.01x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 99 | $120.9K | $1.2K | 3.63x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 5.1K | $114.6K | $22.36 | 5.08x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 86 | $101.3K | $1.2K | 4.55x |
| 22634 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 220 | $88.3K | $401.46 | 5.34x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 269 | $87.2K | $324.01 | 3.45x |
| 72148 | MRI scan of lower spinal canal | 528 | $83.2K | $157.49 | 8.89x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 412 | $70.0K | $169.83 | 7.93x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 2.3K | $69.6K | $29.87 | 6.63x |
| 22830 | Exploration of spinal fusion | 194 | $65.8K | $338.96 | 7.05x |
| 27280 | Fusion of sacroiliac joint obtaining bone graft open procedure | 44 | $58.1K | $1.3K | 3.97x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 458 | $52.7K | $114.96 | 3.11x |
| 63081 | Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach | 34 | $46.2K | $1.4K | 3.45x |
This provider submits charges 5.23 times higher than what Medicare actually pays.
A markup ratio of 5.23x means for every $100 Medicare pays, this provider initially charges $523. 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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