This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 58% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 62% 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 | $142.12 | $104.79 | 1.36x | $37.33 | $277.6K | 5.5K | 3.5K |
| 2015 | $181.28 | $132.88 | 1.36x | $48.40 | $359.0K | 6.0K | 3.6K |
| 2016 | $206.02 | $133.67 | 1.54x | $72.35 | $374.1K | 5.9K | 3.7K |
| 2017 | $244.35 | $144.41 | 1.69x | $99.94 | $356.2K | 5.7K | 2.7K |
| 2018 | $223.36 | $128.44 | 1.74x | $94.92 | $355.2K | 5.9K | 2.6K |
| 2019 | $343.93 | $242.52 | 1.42x | $101.41 | $437.4K | 4.9K | 2.4K |
| 2020 | $259.17 | $194.89 | 1.33x | $64.28 | $302.6K | 3.6K | 2.3K |
| 2021 | $1.1K | $208.66 | 5.36x | $908.97 | $488.9K | 4.5K | 3.0K |
| 2022 | $1.5K | $244.86 | 6.28x | $1.3K | $506.3K | 4.7K | 3.2K |
| 2023 | $1.5K | $224.81 | 6.66x | $1.3K | $438.3K | 4.9K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.8K | $640.6K | $59.40 | 1.54x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 10.9K | $613.7K | $56.16 | 2.63x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 720 | $547.0K | $759.73 | 1.81x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 3.1K | $468.7K | $150.31 | 1.65x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.8K | $363.6K | $94.52 | 2.23x |
| 27447 | Repair of knee joint | 220 | $222.6K | $1.0K | 3.37x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 142 | $120.7K | $850.05 | 5.34x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 768 | $99.6K | $129.64 | 2.78x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.2K | $97.0K | $81.61 | 1.59x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 170 | $96.0K | $564.65 | 2.40x |
| 27245 | Surgical treatment of broken thigh bone | 75 | $77.4K | $1.0K | 3.44x |
| 73560 | X-ray of knee, 1 or 2 views | 3.0K | $74.1K | $24.75 | 2.23x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 68 | $66.5K | $977.55 | 2.64x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 330 | $51.0K | $154.42 | 1.41x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.4K | $34.6K | $24.22 | 2.19x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.5K | $32.9K | $22.22 | 3.11x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 265 | $30.4K | $114.62 | 1.56x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.0K | $29.8K | $29.26 | 2.53x |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 4.8K | $22.5K | $4.73 | 1.87x |
| 73565 | X-ray of both knees, standing, front to back view | 790 | $22.1K | $28.00 | 1.76x |
This provider submits charges 2.22 times higher than what Medicare actually pays.
A markup ratio of 2.22x means for every $100 Medicare pays, this provider initially charges $222. 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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