This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Hand 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 58% 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 | $766.12 | $167.99 | 4.56x | $598.13 | $396.9K | 6.6K | 4.8K |
| 2015 | $729.75 | $162.83 | 4.48x | $566.92 | $469.6K | 7.8K | 5.6K |
| 2016 | $767.03 | $175.47 | 4.37x | $591.56 | $382.3K | 7.2K | 5.0K |
| 2017 | $748.91 | $168.04 | 4.46x | $580.87 | $445.7K | 7.7K | 5.4K |
| 2018 | $756.90 | $169.16 | 4.47x | $587.74 | $508.6K | 8.7K | 6.1K |
| 2019 | $800.38 | $180.01 | 4.45x | $620.37 | $500.1K | 8.6K | 5.8K |
| 2020 | $853.96 | $192.19 | 4.44x | $661.77 | $380.9K | 6.8K | 4.6K |
| 2021 | $930.71 | $223.34 | 4.17x | $707.37 | $602.0K | 8.6K | 5.8K |
| 2022 | $864.80 | $202.50 | 4.27x | $662.30 | $598.4K | 8.6K | 6.0K |
| 2023 | $887.70 | $209.95 | 4.23x | $677.75 | $528.1K | 7.9K | 5.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.3K | $1.2M | $95.63 | 1.89x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.8K | $793.0K | $67.05 | 2.22x |
| 23472 | Prosthetic repair of shoulder joint | 251 | $333.6K | $1.3K | 5.70x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.3K | $284.3K | $86.35 | 2.50x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 5.1K | $282.9K | $55.62 | 3.05x |
| 64721 | Release and/or relocation of median nerve of hand | 697 | $263.9K | $378.56 | 4.54x |
| 73130 | X-ray of hand, minimum of 3 views | 7.5K | $226.6K | $30.05 | 3.49x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 4.5K | $213.0K | $47.84 | 3.50x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 188 | $180.7K | $961.16 | 2.73x |
| 73030 | X-ray of shoulder, minimum of 2 views | 6.3K | $177.8K | $28.23 | 3.72x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.0K | $138.2K | $137.83 | 2.18x |
| 20600 | Aspiration and/or injection of small joint or joint capsule | 2.3K | $93.7K | $41.60 | 2.92x |
| 26055 | Incision of tendon covering | 381 | $84.0K | $220.54 | 5.97x |
| 23430 | Anchoring of biceps tendon | 194 | $66.6K | $343.06 | 4.87x |
| 20605 | Aspiration and/or injection of medium joint or joint capsule | 1.6K | $65.9K | $42.00 | 3.21x |
| 73110 | X-ray of wrist, minimum of 3 views | 2.0K | $65.8K | $33.70 | 3.18x |
| 29828 | Release of shoulder biceps tendon using an endoscope | 114 | $49.1K | $430.27 | 4.76x |
| 29075 | Application of cast, elbow to finger (short arm) | 540 | $43.2K | $80.08 | 2.80x |
| 72040 | X-ray of spine of neck, 2 or 3 views | 964 | $32.6K | $33.79 | 3.10x |
| 29826 | Shaving of shoulder bone using an endoscope | 179 | $28.6K | $159.74 | 13.77x |
This provider submits charges 3.12 times higher than what Medicare actually pays.
A markup ratio of 3.12x means for every $100 Medicare pays, this provider initially charges $312. 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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