This provider's $3.9M 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 | $511.29 | $114.57 | 4.46x | $396.72 | $338.6K | 5.3K | 3.7K |
| 2015 | $666.80 | $156.14 | 4.27x | $510.66 | $405.7K | 5.9K | 4.1K |
| 2016 | $677.94 | $157.57 | 4.30x | $520.37 | $436.5K | 5.6K | 3.8K |
| 2017 | $521.85 | $128.47 | 4.06x | $393.38 | $366.0K | 4.7K | 3.3K |
| 2018 | $835.18 | $187.83 | 4.45x | $647.35 | $329.2K | 4.0K | 3.1K |
| 2019 | $597.79 | $154.51 | 3.87x | $443.28 | $401.1K | 4.4K | 3.4K |
| 2020 | $679.55 | $175.40 | 3.87x | $504.15 | $361.0K | 3.7K | 2.9K |
| 2021 | $623.28 | $146.13 | 4.27x | $477.15 | $380.6K | 3.5K | 2.9K |
| 2022 | $617.92 | $130.71 | 4.73x | $487.21 | $434.6K | 4.3K | 3.4K |
| 2023 | $1.2K | $185.15 | 6.74x | $1.1K | $414.4K | 4.5K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 543 | $653.3K | $1.2K | 5.69x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 830 | $582.1K | $701.36 | 1.66x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 743 | $494.8K | $665.99 | 2.04x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 7.7K | $433.2K | $56.35 | 5.56x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.2K | $416.2K | $57.65 | 2.96x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.9K | $344.2K | $87.94 | 2.90x |
| 73564 | X-ray of knee, 4 or more views | 5.3K | $204.6K | $38.73 | 3.79x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.0K | $154.9K | $77.82 | 3.17x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 903 | $120.0K | $132.87 | 1.73x |
| 73562 | X-ray of knee, 3 views | 2.6K | $75.4K | $28.47 | 3.71x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 52 | $61.9K | $1.2K | 5.52x |
| 73721 | MRI scan of leg joint | 382 | $48.1K | $126.01 | 9.29x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 346 | $40.3K | $116.36 | 3.24x |
| J0702 | Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg | 6.4K | $32.3K | $5.04 | 2.24x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 955 | $30.6K | $32.00 | 4.12x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.1K | $28.1K | $25.75 | 3.99x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1.3K | $26.7K | $21.23 | 3.26x |
| 29880 | Removal of both knee cartilages using an endoscope | 41 | $20.1K | $490.92 | 6.23x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 539 | $15.3K | $28.36 | 3.78x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 565 | $10.4K | $18.37 | 3.54x |
This provider submits charges 3.59 times higher than what Medicare actually pays.
A markup ratio of 3.59x means for every $100 Medicare pays, this provider initially charges $359. 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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