This provider's $6.3M 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 | $625.64 | $166.90 | 3.75x | $458.74 | $540.7K | 4.5K | 2.8K |
| 2015 | $764.41 | $192.97 | 3.96x | $571.44 | $591.3K | 4.4K | 2.9K |
| 2016 | $713.30 | $175.88 | 4.06x | $537.42 | $558.1K | 4.1K | 2.9K |
| 2017 | $839.89 | $215.32 | 3.90x | $624.57 | $652.9K | 4.2K | 3.3K |
| 2018 | $860.14 | $234.34 | 3.67x | $625.80 | $611.2K | 4.0K | 3.3K |
| 2019 | $887.85 | $216.25 | 4.11x | $671.60 | $691.1K | 4.5K | 3.5K |
| 2020 | $825.44 | $206.54 | 4.00x | $618.90 | $640.3K | 4.2K | 3.1K |
| 2021 | $937.00 | $226.37 | 4.14x | $710.63 | $755.6K | 4.6K | 3.5K |
| 2022 | $939.23 | $222.79 | 4.22x | $716.44 | $647.2K | 3.9K | 3.1K |
| 2023 | $849.95 | $210.67 | 4.03x | $639.28 | $616.6K | 3.9K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.9K | $2.3M | $1.2K | 4.04x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.6K | $1.9M | $1.2K | 3.92x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.3K | $610.6K | $96.42 | 3.21x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.5K | $594.7K | $62.71 | 3.30x |
| 73562 | X-ray of knee, 3 views | 9.4K | $315.5K | $33.55 | 3.40x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 5.7K | $217.9K | $38.52 | 3.48x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.9K | $162.5K | $87.65 | 3.54x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 1.4K | $44.7K | $32.81 | 3.69x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 696 | $39.1K | $56.21 | 4.79x |
| 73522 | X-ray of both hips with pelvis, 3-4 views | 606 | $26.2K | $43.26 | 3.65x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 149 | $19.5K | $130.69 | 2.68x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 893 | $19.0K | $21.33 | 3.06x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 849 | $15.6K | $18.34 | 3.05x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 15 | $9.6K | $641.71 | 2.34x |
| 73564 | X-ray of knee, 4 or more views | 245 | $8.7K | $35.62 | 3.71x |
| 73721 | MRI scan of leg joint | 44 | $6.5K | $147.62 | 8.26x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 174 | $5.9K | $33.79 | 3.79x |
| 73520 | X-ray of both hips minimum 2 views | 165 | $5.8K | $35.25 | 3.66x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 129 | $3.3K | $25.37 | 2.44x |
| 72148 | Mri scan of lower spinal canal | 27 | $3.2K | $117.40 | 10.38x |
This provider submits charges 3.78 times higher than what Medicare actually pays.
A markup ratio of 3.78x means for every $100 Medicare pays, this provider initially charges $378. 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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