This provider's $9.4M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $891.17 | $244.80 | 3.64x | $646.37 | $939.5K | 10.5K | 7.3K |
| 2015 | $1.0K | $279.30 | 3.61x | $729.47 | $966.3K | 10.5K | 7.6K |
| 2016 | $960.57 | $260.94 | 3.68x | $699.63 | $961.9K | 10.3K | 7.9K |
| 2017 | $1.0K | $276.72 | 3.72x | $752.17 | $913.4K | 9.9K | 7.7K |
| 2018 | $1.1K | $291.62 | 3.71x | $790.54 | $923.5K | 9.5K | 7.3K |
| 2019 | $1.1K | $302.21 | 3.67x | $805.79 | $981.3K | 9.4K | 7.0K |
| 2020 | $1.2K | $348.14 | 3.43x | $845.76 | $841.7K | 8.1K | 6.0K |
| 2021 | $1.0K | $276.98 | 3.62x | $726.05 | $921.7K | 8.3K | 6.3K |
| 2022 | $1.0K | $276.92 | 3.73x | $756.37 | $966.2K | 8.3K | 6.4K |
| 2023 | $1.2K | $322.65 | 3.73x | $880.76 | $959.6K | 8.0K | 6.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 2.3K | $2.8M | $1.2K | 4.04x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.0K | $1.2M | $1.2K | 4.22x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 20.0K | $1.2M | $57.58 | 2.41x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.1K | $474.8K | $92.42 | 2.25x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 6.1K | $465.5K | $76.38 | 2.76x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 9.7K | $457.8K | $47.16 | 2.98x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 264 | $415.4K | $1.6K | 3.16x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 222 | $339.7K | $1.5K | 3.43x |
| 29879 | Repair of knee joint using an endoscope | 588 | $335.9K | $571.25 | 2.59x |
| 73564 | X-ray of knee, 4 or more views | 10.1K | $317.2K | $31.53 | 2.63x |
| 73562 | X-ray of knee, 3 views | 9.0K | $259.6K | $28.70 | 2.59x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 5.7K | $185.6K | $32.72 | 2.55x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 1.5K | $181.4K | $120.72 | 2.72x |
| 27486 | Revision of one component of total knee joint prosthesis | 133 | $148.6K | $1.1K | 3.05x |
| 29880 | Removal of both knee cartilages using an endoscope | 536 | $69.1K | $128.85 | 15.44x |
| 72170 | X-ray of pelvis, 1 or 2 views | 3.0K | $68.1K | $22.37 | 2.98x |
| 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 | 1.4K | $61.7K | $42.70 | 2.86x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 535 | $57.9K | $108.16 | 2.59x |
| 27506 | Open treatment of broken thigh bone | 78 | $57.6K | $738.07 | 3.98x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 1.4K | $41.0K | $28.35 | 2.63x |
This provider submits charges 3.43 times higher than what Medicare actually pays.
A markup ratio of 3.43x means for every $100 Medicare pays, this provider initially charges $343. 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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