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.
Notable: Payments increased 63% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $775.29 | $160.35 | 4.83x | $614.94 | $226.5K | 3.4K | 2.3K |
| 2015 | $788.63 | $171.57 | 4.60x | $617.06 | $308.1K | 3.5K | 2.5K |
| 2016 | $998.13 | $201.15 | 4.96x | $796.98 | $338.4K | 3.9K | 2.6K |
| 2017 | $917.79 | $178.07 | 5.15x | $739.72 | $355.3K | 4.2K | 3.0K |
| 2018 | $1.0K | $197.51 | 5.23x | $836.19 | $362.1K | 3.6K | 2.6K |
| 2019 | $1.0K | $223.70 | 4.58x | $800.66 | $340.9K | 3.3K | 2.4K |
| 2020 | $1.0K | $229.81 | 4.45x | $792.28 | $318.8K | 2.6K | 2.0K |
| 2021 | $1.1K | $315.95 | 3.58x | $815.37 | $520.3K | 3.1K | 2.4K |
| 2022 | $1.1K | $221.77 | 4.74x | $828.84 | $372.1K | 3.1K | 2.4K |
| 2023 | $929.60 | $167.29 | 5.56x | $762.31 | $288.9K | 3.4K | 2.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 923 | $973.8K | $1.1K | 5.48x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 568 | $598.8K | $1.1K | 5.23x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 322 | $298.2K | $926.04 | 1.63x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 5.5K | $278.3K | $50.78 | 3.82x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.6K | $275.3K | $76.49 | 2.70x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.0K | $258.2K | $51.62 | 3.03x |
| Q4206 | Fluid flow or fluid gf, 1 cc | 99 | $161.8K | $1.6K | 1.35x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 1.5K | $95.9K | $65.11 | 2.03x |
| 73562 | X-ray of knee, 3 views | 3.9K | $95.8K | $24.66 | 4.47x |
| 29881 | Removal of one knee cartilage using an endoscope | 161 | $67.0K | $416.15 | 5.08x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 881 | $64.5K | $73.21 | 3.33x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.2K | $63.8K | $28.48 | 3.69x |
| 29880 | Removal of both knee cartilages using an endoscope | 90 | $39.6K | $440.50 | 7.15x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 340 | $37.6K | $110.57 | 3.92x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 410 | $21.1K | $51.57 | 2.52x |
| 73560 | X-ray of knee, 1 or 2 views | 1.0K | $20.6K | $20.39 | 4.44x |
| J0702 | Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg | 3.4K | $16.5K | $4.85 | 3.44x |
| 77073 | Imaging for bone length assessment | 383 | $11.1K | $28.98 | 6.53x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 1.6K | $8.7K | $5.56 | 2.71x |
| 72170 | X-ray of pelvis, 1 or 2 views | 370 | $7.1K | $19.22 | 5.67x |
This provider submits charges 4.11 times higher than what Medicare actually pays.
A markup ratio of 4.11x means for every $100 Medicare pays, this provider initially charges $411. 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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