This provider's $4.9M 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 | $589.70 | $133.78 | 4.41x | $455.92 | $387.4K | 5.0K | 3.3K |
| 2015 | $430.37 | $118.43 | 3.63x | $311.94 | $402.8K | 5.4K | 3.5K |
| 2016 | $462.23 | $137.97 | 3.35x | $324.26 | $402.1K | 5.4K | 3.4K |
| 2017 | $458.56 | $134.22 | 3.42x | $324.34 | $483.0K | 5.3K | 4.0K |
| 2018 | $729.88 | $218.94 | 3.33x | $510.94 | $493.6K | 4.9K | 3.8K |
| 2019 | $662.19 | $195.03 | 3.40x | $467.16 | $636.7K | 5.3K | 4.2K |
| 2020 | $494.92 | $141.21 | 3.50x | $353.71 | $415.1K | 3.8K | 3.1K |
| 2021 | $509.97 | $144.71 | 3.52x | $365.26 | $609.4K | 4.9K | 3.6K |
| 2022 | $539.39 | $151.64 | 3.56x | $387.75 | $576.8K | 4.7K | 3.5K |
| 2023 | $526.14 | $142.02 | 3.70x | $384.12 | $528.2K | 4.6K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 1.1K | $670.9K | $634.67 | 3.54x |
| 27447 | Repair of knee joint | 571 | $649.6K | $1.1K | 3.33x |
| 72148 | MRI scan of lower spinal canal | 3.5K | $456.5K | $129.34 | 3.91x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 4.7K | $432.1K | $92.18 | 3.55x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.2K | $397.0K | $64.14 | 3.10x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.1K | $387.0K | $95.20 | 3.12x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 890 | $363.5K | $408.38 | 3.43x |
| 73721 | MRI scan of leg joint | 1.7K | $254.0K | $147.74 | 4.07x |
| 76882 | Ultrasound of arm or leg | 4.6K | $193.5K | $42.30 | 2.35x |
| 73564 | X-ray of knee, 4 or more views | 4.0K | $151.4K | $37.54 | 3.08x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $149.1K | $127.68 | 3.53x |
| 73221 | MRI scan of arm joint | 1.0K | $147.3K | $146.38 | 3.95x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 1.1K | $140.5K | $133.33 | 2.94x |
| 72141 | MRI scan of upper spinal canal | 978 | $115.9K | $118.51 | 4.21x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 460 | $57.1K | $124.04 | 3.27x |
| 72146 | MRI scan of middle spinal canal | 479 | $56.9K | $118.77 | 4.19x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 649 | $53.8K | $82.96 | 3.53x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 636 | $40.6K | $63.84 | 9.19x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.3K | $34.1K | $27.29 | 3.05x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 864 | $34.1K | $39.44 | 4.63x |
This provider submits charges 3.51 times higher than what Medicare actually pays.
A markup ratio of 3.51x means for every $100 Medicare pays, this provider initially charges $351. 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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