This provider's $6.0M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 6.44x is significantly above the specialty median of 4.7x.
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 | $1.3K | $109.35 | 12.08x | $1.2K | $643.8K | 10.9K | 6.3K |
| 2015 | $1.2K | $111.65 | 10.79x | $1.1K | $694.2K | 12.1K | 6.6K |
| 2016 | $1.3K | $136.47 | 9.71x | $1.2K | $789.3K | 12.2K | 6.7K |
| 2017 | $1.4K | $118.99 | 11.38x | $1.2K | $665.7K | 10.7K | 5.8K |
| 2018 | $1.6K | $133.03 | 12.12x | $1.5K | $594.8K | 8.1K | 4.9K |
| 2019 | $1.8K | $154.00 | 11.43x | $1.6K | $562.0K | 5.8K | 4.0K |
| 2020 | $2.1K | $157.70 | 13.59x | $2.0K | $465.2K | 6.2K | 3.5K |
| 2021 | $2.2K | $171.99 | 12.94x | $2.1K | $533.8K | 6.5K | 3.7K |
| 2022 | $1.7K | $135.56 | 12.72x | $1.6K | $554.4K | 7.1K | 4.1K |
| 2023 | $1.9K | $162.02 | 11.99x | $1.8K | $462.5K | 6.1K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 15.3K | $1.3M | $84.49 | 5.27x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 8.0K | $1.0M | $129.21 | 3.98x |
| 27447 | Repair of knee joint | 622 | $741.4K | $1.2K | 10.64x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.8K | $668.2K | $61.71 | 2.15x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 304 | $366.3K | $1.2K | 20.07x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.3K | $276.7K | $84.20 | 1.96x |
| 73562 | X-ray of knee, 3 views | 7.6K | $252.3K | $33.23 | 4.78x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.1K | $174.8K | $81.54 | 2.60x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 6.3K | $136.2K | $21.54 | 4.23x |
| 73721 | MRI scan of leg joint | 1.0K | $133.6K | $132.13 | 14.76x |
| 72170 | X-ray of pelvis, 1 or 2 views | 5.5K | $130.8K | $23.71 | 6.90x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 1.4K | $80.2K | $55.45 | 6.96x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 4.3K | $78.8K | $18.31 | 3.99x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 1.3K | $78.5K | $61.33 | 13.30x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 524 | $64.4K | $122.85 | 2.46x |
| 72148 | MRI scan of lower spinal canal | 517 | $63.2K | $122.18 | 19.89x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 1.4K | $51.3K | $35.39 | 3.96x |
| 97001 | Physical therapy evaluation | 603 | $35.8K | $59.31 | 3.19x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 1.4K | $34.1K | $24.91 | 3.21x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 230 | $27.0K | $117.46 | 1.75x |
This provider submits charges 6.44 times higher than what Medicare actually pays.
A markup ratio of 6.44x means for every $100 Medicare pays, this provider initially charges $644. 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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