This provider's $3.7M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.74x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 11105% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 15889% in 2016
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 | $139.95 | $67.83 | 2.06x | $72.12 | $5.2K | 84 | 63 |
| 2015 | $311.54 | $58.59 | 5.32x | $252.95 | $1.2K | 20 | 20 |
| 2016 | $890.54 | $226.29 | 3.94x | $664.25 | $187.4K | 1.9K | 1.5K |
| 2017 | $1.9K | $306.90 | 6.30x | $1.6K | $444.6K | 3.8K | 2.9K |
| 2018 | $2.1K | $308.98 | 6.80x | $1.8K | $283.1K | 2.5K | 2.1K |
| 2019 | $2.0K | $311.95 | 6.27x | $1.6K | $577.7K | 4.3K | 3.4K |
| 2020 | $2.1K | $337.26 | 6.15x | $1.7K | $419.2K | 3.4K | 2.6K |
| 2021 | $1.9K | $316.82 | 6.09x | $1.6K | $550.3K | 4.0K | 3.2K |
| 2022 | $2.1K | $309.79 | 6.65x | $1.7K | $612.4K | 4.3K | 3.4K |
| 2023 | $2.1K | $308.57 | 6.81x | $1.8K | $586.6K | 4.4K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 64483 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 2.6K | $473.3K | $185.17 | 7.37x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.6K | $392.7K | $86.23 | 2.37x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.2K | $240.2K | $57.44 | 2.43x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 189 | $227.4K | $1.2K | 5.92x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 168 | $226.3K | $1.3K | 5.64x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 207 | $212.0K | $1.0K | 6.73x |
| 64484 | Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance | 2.5K | $203.7K | $83.00 | 7.41x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 265 | $181.1K | $683.52 | 7.35x |
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 110 | $162.6K | $1.5K | 6.25x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 268 | $155.5K | $580.08 | 5.78x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 484 | $99.8K | $206.21 | 10.88x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 144 | $87.0K | $603.89 | 6.09x |
| 22214 | Incision of spine to correct deformity at lower spinal column | 135 | $86.3K | $639.27 | 10.44x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 222 | $69.4K | $312.68 | 6.56x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 107 | $65.7K | $614.34 | 5.51x |
| 27245 | Surgical treatment of broken thigh bone | 66 | $64.7K | $980.10 | 5.15x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 549 | $62.5K | $113.81 | 2.64x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 1.6K | $56.4K | $36.16 | 4.96x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 360 | $49.3K | $136.87 | 2.32x |
| 61783 | Computer-assisted spinal procedure | 249 | $46.0K | $184.69 | 5.70x |
This provider submits charges 5.74 times higher than what Medicare actually pays.
A markup ratio of 5.74x means for every $100 Medicare pays, this provider initially charges $574. 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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