This provider's $5.0M in total Medicare payments ranks in the 93th percentile of Ambulatory Surgical Center providers nationally.
Medicare payments to this provider grew 2812% from 2020 to 2023.
67% of their billing comes from a single procedure code (27447 — Repair of knee joint).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 826% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $35.0K | $6.9K | 5.11x | $28.1K | $82.2K | 12 | 12 |
| 2021 | $35.7K | $7.0K | 5.10x | $28.7K | $761.8K | 109 | 106 |
| 2022 | $21.1K | $4.4K | 4.82x | $16.7K | $1.8M | 276 | 270 |
| 2023 | $16.1K | $3.5K | 4.58x | $12.6K | $2.4M | 394 | 386 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 472 | $3.4M | $7.1K | 4.90x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 209 | $1.5M | $7.2K | 5.02x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 45 | $103.8K | $2.3K | 2.25x |
| 29881 | Removal of knee cartilage using an endoscope | 14 | $14.9K | $1.1K | 7.42x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 12 | $7.2K | $601.48 | 6.65x |
| C9290 | Injection, bupivacaine liposome, 1 mg | 39 | $43.68 | $1.12 | 5.77x |
This provider submits charges 4.89 times higher than what Medicare actually pays.
A markup ratio of 4.89x means for every $100 Medicare pays, this provider initially charges $489. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulatory Surgical Center providers in PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Main Line Surgery Center, Llc | Bala Cynwyd, PA | $38.7M | ✓ Clear |
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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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