This provider's $3.4M in total Medicare payments ranks in the 98th 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 | $397.04 | $100.82 | 3.94x | $296.22 | $415.2K | 10.0K | 5.0K |
| 2015 | $322.77 | $95.00 | 3.40x | $227.77 | $405.7K | 10.2K | 5.0K |
| 2016 | $321.15 | $103.41 | 3.11x | $217.74 | $387.0K | 9.6K | 4.4K |
| 2017 | $300.31 | $107.47 | 2.79x | $192.84 | $358.7K | 8.8K | 4.0K |
| 2018 | $245.07 | $89.55 | 2.74x | $155.52 | $335.6K | 8.1K | 4.1K |
| 2019 | $250.67 | $94.96 | 2.64x | $155.71 | $347.8K | 8.0K | 4.0K |
| 2020 | $181.07 | $71.02 | 2.55x | $110.05 | $282.4K | 7.2K | 3.5K |
| 2021 | $122.85 | $44.01 | 2.79x | $78.84 | $304.9K | 7.7K | 3.5K |
| 2022 | $175.52 | $64.97 | 2.70x | $110.55 | $284.5K | 7.1K | 3.2K |
| 2023 | $117.80 | $41.69 | 2.83x | $76.11 | $266.6K | 6.4K | 2.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 64445 | Injection of anesthetic agent, sciatic nerve | 5.9K | $559.7K | $94.43 | 2.63x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.2K | $546.6K | $53.44 | 2.60x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 12.7K | $485.5K | $38.29 | 4.37x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.5K | $290.6K | $82.32 | 2.59x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.8K | $193.9K | $110.60 | 2.78x |
| 20553 | Injections of trigger points in 3 or more muscles | 6.2K | $167.6K | $27.15 | 4.79x |
| 20551 | Injections of tendon attachment to bone | 6.2K | $161.2K | $25.82 | 4.31x |
| 27447 | Repair of knee joint | 136 | $139.2K | $1.0K | 3.10x |
| 20605 | Aspiration and/or injection of medium joint or joint capsule | 4.5K | $105.7K | $23.55 | 4.80x |
| 23412 | Repair of torn tendons of shoulder, open procedure | 116 | $73.6K | $634.27 | 2.78x |
| 27236 | Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement | 78 | $70.6K | $904.97 | 2.88x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 13.1K | $55.0K | $4.21 | 4.46x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 333 | $50.6K | $151.87 | 2.38x |
| 73560 | X-ray of knee, 1 or 2 views | 2.2K | $46.2K | $20.93 | 2.53x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.4K | $34.1K | $25.04 | 2.56x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.5K | $30.2K | $20.76 | 2.51x |
| 72040 | X-ray of spine of neck, 2 or 3 views | 1.1K | $27.4K | $24.10 | 2.59x |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 3.0K | $27.2K | $8.98 | 2.44x |
| 29879 | Repair of knee joint using an endoscope | 54 | $25.6K | $473.23 | 3.08x |
| 10160 | Aspiration of abscess, blood accumulation, blister, or cyst | 289 | $24.4K | $84.40 | 2.83x |
This provider submits charges 3.22 times higher than what Medicare actually pays.
A markup ratio of 3.22x means for every $100 Medicare pays, this provider initially charges $322. 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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