This provider's $8.7M 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 | $723.42 | $166.94 | 4.33x | $556.48 | $767.9K | 11.5K | 7.6K |
| 2015 | $723.20 | $160.14 | 4.52x | $563.06 | $598.2K | 8.6K | 6.0K |
| 2016 | $687.98 | $159.98 | 4.30x | $528.00 | $891.5K | 14.4K | 8.3K |
| 2017 | $724.23 | $161.62 | 4.48x | $562.61 | $833.3K | 14.2K | 8.0K |
| 2018 | $700.13 | $162.50 | 4.31x | $537.63 | $827.9K | 14.2K | 7.6K |
| 2019 | $696.04 | $178.59 | 3.90x | $517.45 | $1.0M | 14.1K | 7.5K |
| 2020 | $730.86 | $216.92 | 3.37x | $513.94 | $767.3K | 11.0K | 6.2K |
| 2021 | $789.28 | $214.23 | 3.68x | $575.05 | $1.1M | 10.0K | 6.1K |
| 2022 | $795.93 | $212.04 | 3.75x | $583.89 | $1.1M | 12.1K | 6.8K |
| 2023 | $734.89 | $175.53 | 4.19x | $559.36 | $780.4K | 12.3K | 6.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 11.5K | $1.5M | $132.76 | 3.97x |
| 27447 | Repair of knee joint | 1.2K | $1.3M | $1.1K | 4.22x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 22.4K | $1.2M | $54.02 | 4.21x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 1.0K | $982.3K | $965.87 | 2.27x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 24.8K | $958.4K | $38.64 | 5.09x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 814 | $879.5K | $1.1K | 4.15x |
| 73565 | X-ray of both knees, standing, front to back view | 11.4K | $299.7K | $26.27 | 4.37x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 7.7K | $275.5K | $35.68 | 3.80x |
| 73560 | X-ray of knee, 1 or 2 views | 11.3K | $263.1K | $23.38 | 4.27x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.4K | $238.8K | $69.57 | 4.68x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 4.3K | $131.9K | $30.36 | 4.04x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $117.8K | $104.44 | 5.09x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.4K | $110.2K | $76.25 | 4.42x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 12.1K | $93.1K | $7.69 | 3.34x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 2.7K | $71.6K | $26.76 | 4.22x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 1.4K | $55.9K | $41.13 | 4.13x |
| 72170 | X-ray of pelvis, 1 or 2 views | 1.6K | $33.2K | $21.27 | 4.59x |
| 73522 | X-ray of both hips with pelvis, 3-4 views | 853 | $29.0K | $34.04 | 4.11x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 985 | $26.9K | $27.35 | 4.51x |
| 77002 | Fluoroscopic guidance for insertion of needle | 260 | $5.6K | $21.73 | 8.90x |
This provider submits charges 4.05 times higher than what Medicare actually pays.
A markup ratio of 4.05x means for every $100 Medicare pays, this provider initially charges $405. 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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