This provider's $8.4M 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 | $822.85 | $213.68 | 3.85x | $609.17 | $795.1K | 8.3K | 6.2K |
| 2015 | $905.94 | $233.00 | 3.89x | $672.94 | $993.3K | 10.0K | 6.6K |
| 2016 | $935.63 | $234.82 | 3.98x | $700.81 | $936.8K | 9.4K | 6.1K |
| 2017 | $821.78 | $204.06 | 4.03x | $617.72 | $872.6K | 7.5K | 5.5K |
| 2018 | $689.94 | $181.03 | 3.81x | $508.91 | $874.5K | 8.4K | 5.8K |
| 2019 | $438.09 | $114.79 | 3.82x | $323.30 | $768.6K | 8.0K | 5.3K |
| 2020 | $576.51 | $150.65 | 3.83x | $425.86 | $722.6K | 7.8K | 5.1K |
| 2021 | $638.16 | $180.98 | 3.53x | $457.18 | $855.7K | 9.3K | 6.0K |
| 2022 | $557.13 | $145.32 | 3.83x | $411.81 | $809.0K | 8.3K | 5.7K |
| 2023 | $623.88 | $165.29 | 3.77x | $458.59 | $814.6K | 7.9K | 5.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 2.8K | $2.8M | $1.0K | 3.59x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 820 | $827.3K | $1.0K | 3.33x |
| 29879 | Repair of knee joint using an endoscope | 1.1K | $518.7K | $480.75 | 3.15x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 3.9K | $437.3K | $111.18 | 5.98x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.8K | $355.6K | $52.31 | 3.10x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.7K | $348.9K | $73.84 | 3.26x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.1K | $338.2K | $108.38 | 3.43x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 3.7K | $272.7K | $74.59 | 4.53x |
| 73564 | X-ray of knee, 4 or more views | 10.2K | $267.6K | $26.31 | 3.71x |
| 27446 | Repair of knee joint | 237 | $200.0K | $844.01 | 3.01x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.4K | $169.3K | $70.85 | 3.43x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 7.3K | $135.1K | $18.45 | 4.61x |
| 73721 | MRI scan of leg joint | 1.1K | $133.4K | $123.65 | 4.62x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 98 | $126.0K | $1.3K | 3.20x |
| 27486 | Revision of one component of total knee joint prosthesis | 102 | $107.7K | $1.1K | 3.12x |
| 29880 | Removal of both knee cartilages using an endoscope | 792 | $105.5K | $133.16 | 9.81x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.2K | $99.0K | $44.25 | 4.38x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 72 | $97.7K | $1.4K | 3.33x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.8K | $77.8K | $27.52 | 3.38x |
| 27360 | Partial removal of bone of thigh and/or lower leg bones | 237 | $77.0K | $324.95 | 5.95x |
This provider submits charges 3.88 times higher than what Medicare actually pays.
A markup ratio of 3.88x means for every $100 Medicare pays, this provider initially charges $388. 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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