This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 9.21x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 71% from 2014 to 2023.
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 | $3.8K | $391.70 | 9.58x | $3.4K | $257.5K | 1.5K | 1.3K |
| 2015 | $3.6K | $380.00 | 9.36x | $3.2K | $302.7K | 1.6K | 1.4K |
| 2016 | $4.1K | $407.54 | 10.16x | $3.7K | $385.4K | 1.9K | 1.6K |
| 2017 | $4.4K | $440.39 | 9.93x | $3.9K | $520.5K | 2.2K | 2.0K |
| 2018 | $4.4K | $413.14 | 10.55x | $3.9K | $564.8K | 2.5K | 2.2K |
| 2019 | $4.6K | $462.46 | 9.97x | $4.1K | $699.6K | 2.6K | 2.3K |
| 2020 | $4.3K | $384.70 | 11.05x | $3.9K | $648.5K | 2.4K | 2.1K |
| 2021 | $4.4K | $402.44 | 11.00x | $4.0K | $521.7K | 2.1K | 1.9K |
| 2022 | $3.6K | $366.41 | 9.69x | $3.2K | $443.1K | 1.8K | 1.6K |
| 2023 | $3.7K | $351.48 | 10.42x | $3.3K | $440.6K | 2.0K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 778 | $1.1M | $1.4K | 9.52x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 787 | $473.3K | $601.37 | 9.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.7K | $451.0K | $121.22 | 3.60x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.7K | $390.6K | $83.26 | 3.38x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 617 | $360.5K | $584.31 | 13.89x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 189 | $229.2K | $1.2K | 8.24x |
| 63042 | Re-exploration of spine repair with release of lower spinal cord or nerves | 253 | $168.3K | $665.15 | 13.82x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 820 | $167.3K | $204.02 | 14.85x |
| 63030 | Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine | 218 | $165.3K | $758.10 | 9.94x |
| 22214 | Incision of spine to correct deformity at lower spinal column | 232 | $137.9K | $594.40 | 14.66x |
| 63655 | Implantation of spinal neurostimulator electrodes | 197 | $128.8K | $653.69 | 10.81x |
| 63081 | Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach | 86 | $119.2K | $1.4K | 7.95x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 194 | $116.9K | $602.43 | 9.77x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 3.1K | $84.2K | $27.02 | 6.14x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 434 | $72.0K | $165.81 | 11.66x |
| 22216 | Incision of spine bone to correct spinal deformity of spinal column | 230 | $66.5K | $289.08 | 8.73x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 107 | $62.2K | $581.25 | 10.03x |
| 27280 | Fusion of sacroiliac joint obtaining bone graft open procedure | 44 | $51.2K | $1.2K | 3.97x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 1.3K | $48.9K | $36.80 | 7.28x |
| 22634 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 114 | $44.5K | $390.70 | 8.89x |
This provider submits charges 9.21 times higher than what Medicare actually pays.
A markup ratio of 9.21x means for every $100 Medicare pays, this provider initially charges $921. 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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