This provider's $9.4M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 79% 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 | $678.22 | $198.15 | 3.42x | $480.07 | $627.3K | 9.1K | 6.1K |
| 2015 | $536.50 | $152.92 | 3.51x | $383.58 | $642.1K | 8.9K | 5.8K |
| 2016 | $530.20 | $162.90 | 3.25x | $367.30 | $684.2K | 8.5K | 5.5K |
| 2017 | $611.84 | $193.23 | 3.17x | $418.61 | $874.2K | 10.0K | 6.8K |
| 2018 | $425.18 | $130.78 | 3.25x | $294.40 | $811.2K | 9.5K | 6.8K |
| 2019 | $771.42 | $264.17 | 2.92x | $507.25 | $1.1M | 11.0K | 8.0K |
| 2020 | $617.61 | $214.52 | 2.88x | $403.09 | $1.1M | 9.8K | 7.0K |
| 2021 | $745.09 | $269.70 | 2.76x | $475.39 | $1.3M | 10.1K | 7.8K |
| 2022 | $546.23 | $180.81 | 3.02x | $365.42 | $1.1M | 9.5K | 7.3K |
| 2023 | $579.28 | $167.82 | 3.45x | $411.46 | $1.1M | 10.8K | 8.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 2.1K | $2.4M | $1.1K | 3.57x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.2K | $1.3M | $1.1K | 3.24x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 16.7K | $927.7K | $55.68 | 2.71x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 10.6K | $830.4K | $78.20 | 3.09x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 837 | $773.7K | $924.36 | 1.74x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.0K | $519.0K | $86.40 | 2.64x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 7.3K | $406.7K | $55.61 | 3.36x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 3.5K | $402.0K | $115.96 | 2.39x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.7K | $318.6K | $116.05 | 3.04x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.8K | $208.9K | $73.82 | 3.10x |
| 73564 | X-ray of knee, 4 or more views | 5.8K | $173.9K | $29.98 | 3.20x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 104 | $150.1K | $1.4K | 3.04x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 4.9K | $98.3K | $20.13 | 3.43x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 775 | $93.3K | $120.38 | 4.15x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 131 | $85.4K | $652.04 | 3.58x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 85 | $83.6K | $983.38 | 2.95x |
| 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 imple | 1.9K | $79.9K | $41.57 | 1.79x |
| 73501 | X-ray of hip with pelvis, 1 view | 3.5K | $74.7K | $21.37 | 3.42x |
| 73560 | X-ray of knee, 1 or 2 views | 3.1K | $67.1K | $21.74 | 3.13x |
| 73562 | X-ray of knee, 3 views | 1.8K | $47.0K | $25.92 | 3.20x |
This provider submits charges 3.1 times higher than what Medicare actually pays.
A markup ratio of 3.1x means for every $100 Medicare pays, this provider initially charges $310. 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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