This provider's $6.0M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 10.18x is significantly above the specialty median of 4.7x.
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 | $3.1K | $319.27 | 9.67x | $2.8K | $659.9K | 6.8K | 5.2K |
| 2015 | $2.9K | $307.43 | 9.45x | $2.6K | $656.8K | 6.1K | 4.8K |
| 2016 | $3.9K | $307.59 | 12.82x | $3.6K | $623.7K | 5.9K | 4.6K |
| 2017 | $4.2K | $295.79 | 14.14x | $3.9K | $639.2K | 5.6K | 4.5K |
| 2018 | $3.9K | $292.92 | 13.17x | $3.6K | $607.8K | 5.5K | 4.6K |
| 2019 | $3.9K | $272.50 | 14.26x | $3.6K | $605.5K | 5.1K | 4.4K |
| 2020 | $3.0K | $318.24 | 9.58x | $2.7K | $467.1K | 2.6K | 2.3K |
| 2021 | $1.6K | $190.29 | 8.15x | $1.4K | $506.8K | 3.6K | 3.1K |
| 2022 | $2.7K | $306.43 | 8.72x | $2.4K | $578.9K | 3.9K | 3.4K |
| 2023 | $2.2K | $246.12 | 8.94x | $2.0K | $632.6K | 4.1K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.7K | $1.9M | $1.1K | 13.25x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 1.5K | $1.7M | $1.1K | 13.12x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 9.7K | $334.2K | $34.47 | 4.77x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.3K | $307.3K | $130.93 | 3.55x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 166 | $253.8K | $1.5K | 11.73x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.3K | $245.2K | $104.48 | 2.87x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.7K | $224.7K | $83.58 | 4.28x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 135 | $196.3K | $1.5K | 12.70x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.6K | $171.6K | $65.83 | 3.75x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.3K | $117.7K | $50.32 | 3.73x |
| 73564 | X-ray of knee, 4 or more views | 7.7K | $95.2K | $12.30 | 4.49x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 187 | $75.4K | $402.96 | 2.01x |
| 13160 | Second repair of surgical wound | 164 | $67.0K | $408.74 | 6.64x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.3K | $35.9K | $15.74 | 4.08x |
| 73522 | X-ray of both hips with pelvis, 3-4 views | 2.6K | $30.6K | $11.68 | 3.88x |
| 27446 | Repair of knee joint | 28 | $27.7K | $988.19 | 9.27x |
| 73562 | X-ray of knee, 3 views | 1.7K | $27.6K | $15.78 | 4.10x |
| 73503 | X-ray of hip with pelvis, minimum of 4 views | 490 | $18.7K | $38.24 | 3.89x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 363 | $16.7K | $46.13 | 3.84x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 223 | $16.5K | $73.82 | 3.78x |
This provider submits charges 10.18 times higher than what Medicare actually pays.
A markup ratio of 10.18x means for every $100 Medicare pays, this provider initially charges $1018. 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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