This provider's $8.5M in total Medicare payments ranks in the 96th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 12.96x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 274% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 176% 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 |
|---|---|---|---|---|---|---|---|
| 2020 | $30.0K | $2.2K | 13.95x | $27.9K | $791.3K | 368 | 9 |
| 2021 | $45.9K | $3.5K | 13.18x | $42.4K | $2.2M | 627 | 10 |
| 2022 | $46.0K | $3.5K | 13.01x | $42.4K | $2.6M | 730 | 10 |
| 2023 | $51.8K | $4.2K | 12.48x | $47.7K | $3.0M | 713 | 9 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Replacement of knee joint, both sides of knee | 633 | $4.1M | $6.5K | 11.60x |
| 27130 | Replacement of thigh bone and hip joint with prosthesis | 462 | $3.0M | $6.5K | 13.00x |
| 29828 | Release of tendon connecting biceps muscle and shoulder using an endoscope | 217 | $470.0K | $2.2K | 10.32x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 319 | $464.1K | $1.5K | 15.37x |
| 29823 | Removal of extensive shoulder joint tissue using an endoscope | 233 | $119.9K | $514.50 | 37.25x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 228 | $113.4K | $497.33 | 38.54x |
| 29881 | Removal of knee cartilage using an endoscope | 107 | $101.9K | $952.70 | 11.32x |
| 29880 | Removal of both knee cartilages using an endoscope | 99 | $95.7K | $966.84 | 11.15x |
| 20680 | Removal of deep implant from bone | 52 | $37.1K | $713.33 | 10.95x |
| 76000 | Imaging guidance for procedure, 60 minutes or less | 88 | $1.7K | $19.79 | 93.86x |
This provider submits charges 12.96 times higher than what Medicare actually pays.
A markup ratio of 12.96x means for every $100 Medicare pays, this provider initially charges $1296. 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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