This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.37x 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 | $1.6K | $334.81 | 4.70x | $1.2K | $414.6K | 2.0K | 1.7K |
| 2015 | $2.2K | $353.36 | 6.16x | $1.8K | $455.9K | 2.1K | 1.7K |
| 2016 | $2.3K | $377.07 | 6.06x | $1.9K | $371.3K | 1.9K | 1.6K |
| 2017 | $2.3K | $374.89 | 6.09x | $1.9K | $325.8K | 1.7K | 1.4K |
| 2018 | $1.8K | $303.74 | 5.86x | $1.5K | $309.0K | 1.8K | 1.5K |
| 2019 | $2.3K | $364.89 | 6.27x | $1.9K | $361.9K | 1.9K | 1.5K |
| 2020 | $2.2K | $353.89 | 6.12x | $1.8K | $390.0K | 2.3K | 1.7K |
| 2021 | $2.8K | $358.60 | 7.75x | $2.4K | $366.8K | 2.4K | 1.6K |
| 2022 | $1.7K | $371.23 | 4.65x | $1.4K | $418.7K | 2.5K | 1.6K |
| 2023 | $1.5K | $327.23 | 4.43x | $1.1K | $461.5K | 2.5K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 642 | $893.9K | $1.4K | 4.87x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 791 | $451.3K | $570.50 | 7.80x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 263 | $322.2K | $1.2K | 4.01x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 480 | $278.6K | $580.39 | 5.75x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 355 | $206.9K | $582.72 | 5.70x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 174 | $198.6K | $1.1K | 4.65x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $168.1K | $119.49 | 3.29x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.0K | $158.1K | $52.55 | 3.26x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.7K | $145.0K | $83.84 | 2.94x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 616 | $121.1K | $196.62 | 7.78x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 4.3K | $109.9K | $25.74 | 4.62x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 2.7K | $105.1K | $39.10 | 3.17x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 538 | $86.5K | $160.76 | 8.47x |
| 22851 | Insertion of spinal instrumentation for spinal stabilization | 266 | $83.1K | $312.30 | 5.62x |
| 22634 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 202 | $76.4K | $378.01 | 6.33x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 105 | $58.8K | $560.05 | 6.52x |
| 22552 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 181 | $54.5K | $301.09 | 3.35x |
| 63030 | Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine | 64 | $44.1K | $688.36 | 7.38x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 69 | $41.4K | $600.38 | 9.41x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 125 | $37.1K | $296.45 | 4.97x |
This provider submits charges 5.37 times higher than what Medicare actually pays.
A markup ratio of 5.37x means for every $100 Medicare pays, this provider initially charges $537. 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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