This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.41x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 95% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 54% in 2021
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 | $430.18 | $292.46 | 1.47x | $137.72 | $337.6K | 3.1K | 2.1K |
| 2015 | $489.41 | $343.39 | 1.43x | $146.02 | $391.7K | 3.5K | 2.4K |
| 2016 | $368.19 | $240.37 | 1.53x | $127.82 | $453.0K | 4.1K | 2.7K |
| 2017 | $344.88 | $231.56 | 1.49x | $113.32 | $434.2K | 3.9K | 2.7K |
| 2018 | $378.20 | $204.04 | 1.85x | $174.16 | $466.9K | 3.8K | 2.9K |
| 2019 | $408.09 | $256.68 | 1.59x | $151.41 | $413.7K | 3.6K | 2.8K |
| 2020 | $399.85 | $277.19 | 1.44x | $122.66 | $461.9K | 3.5K | 2.6K |
| 2021 | $4.0K | $238.14 | 16.62x | $3.7K | $709.3K | 4.6K | 3.0K |
| 2022 | $3.9K | $210.87 | 18.69x | $3.7K | $713.7K | 4.9K | 3.5K |
| 2023 | $3.9K | $212.33 | 18.25x | $3.7K | $658.5K | 4.5K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 984 | $1.1M | $1.2K | 7.81x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.0K | $769.7K | $95.72 | 2.47x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 541 | $630.9K | $1.2K | 15.91x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 687 | $542.3K | $789.43 | 1.60x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.2K | $386.4K | $62.38 | 1.92x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 5.3K | $310.4K | $58.54 | 3.16x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 434 | $282.9K | $651.76 | 2.39x |
| 73721 | MRI scan of leg joint | 1.3K | $194.0K | $146.38 | 6.29x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 947 | $123.6K | $130.51 | 2.18x |
| 73562 | X-ray of knee, 3 views | 3.7K | $118.6K | $32.31 | 2.89x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 950 | $117.9K | $124.06 | 1.76x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.6K | $94.8K | $36.99 | 3.02x |
| 73564 | X-ray of knee, 4 or more views | 2.5K | $91.0K | $36.04 | 2.88x |
| 29881 | Removal of one knee cartilage using an endoscope | 93 | $44.5K | $478.03 | 3.51x |
| 27245 | Surgical treatment of broken thigh bone | 29 | $31.6K | $1.1K | 1.28x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 770 | $25.0K | $32.53 | 1.40x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 24 | $24.8K | $1.0K | 1.57x |
| J3304 | Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg | 1.4K | $18.9K | $13.65 | 2.20x |
| G0180 | Physician 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 to affirm the initial implem | 349 | $16.5K | $47.30 | 1.56x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 89 | $15.4K | $172.76 | 1.30x |
This provider submits charges 5.41 times higher than what Medicare actually pays.
A markup ratio of 5.41x means for every $100 Medicare pays, this provider initially charges $541. 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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