This provider's $3.7M in total Medicare payments ranks in the 99th percentile of Sports Medicine 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 | $941.03 | $203.67 | 4.62x | $737.36 | $303.1K | 4.6K | 3.3K |
| 2015 | $896.31 | $206.69 | 4.34x | $689.62 | $376.0K | 5.0K | 3.6K |
| 2016 | $1.1K | $212.13 | 5.07x | $862.94 | $343.8K | 5.1K | 3.5K |
| 2017 | $1.2K | $211.43 | 5.81x | $1.0K | $420.6K | 4.7K | 3.6K |
| 2018 | $1.2K | $206.07 | 6.03x | $1.0K | $443.9K | 5.0K | 4.0K |
| 2019 | $1.2K | $240.59 | 5.18x | $1.0K | $441.1K | 4.0K | 3.2K |
| 2020 | $1.3K | $243.85 | 5.14x | $1.0K | $365.8K | 3.8K | 3.0K |
| 2021 | $1.2K | $199.51 | 5.92x | $981.02 | $332.1K | 3.5K | 2.9K |
| 2022 | $1.2K | $215.71 | 5.44x | $958.04 | $343.7K | 3.3K | 2.8K |
| 2023 | $1.2K | $214.53 | 5.51x | $967.26 | $357.0K | 2.8K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 887 | $879.5K | $991.55 | 5.65x |
| 23472 | Prosthetic repair of shoulder joint | 463 | $504.3K | $1.1K | 4.31x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 576 | $449.9K | $781.00 | 3.76x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 7.3K | $328.7K | $44.75 | 3.54x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.7K | $291.5K | $51.08 | 2.29x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 299 | $182.1K | $609.07 | 2.35x |
| 29824 | Partial removal of collar bone at shoulder using an endoscope | 749 | $173.8K | $232.02 | 7.88x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.6K | $114.5K | $70.49 | 3.11x |
| 29826 | Shaving of shoulder bone using an endoscope | 766 | $101.0K | $131.92 | 18.35x |
| 73030 | X-ray of shoulder, minimum of 2 views | 4.2K | $86.6K | $20.87 | 5.04x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.6K | $79.6K | $30.63 | 2.77x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 923 | $75.8K | $82.17 | 2.05x |
| 73221 | MRI scan of arm joint | 649 | $71.9K | $110.76 | 8.59x |
| 73564 | X-ray of knee, 4 or more views | 2.2K | $63.4K | $28.58 | 4.69x |
| 73560 | X-ray of knee, 1 or 2 views | 2.8K | $57.1K | $20.78 | 4.31x |
| 29828 | Release of shoulder biceps tendon using an endoscope | 123 | $52.3K | $425.08 | 6.98x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 347 | $38.7K | $111.47 | 2.72x |
| 29881 | Removal of one knee cartilage using an endoscope | 85 | $30.1K | $353.60 | 5.73x |
| 73721 | MRI scan of leg joint | 264 | $29.3K | $111.14 | 8.61x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 5.3K | $22.2K | $4.19 | 3.31x |
This provider submits charges 4.88 times higher than what Medicare actually pays.
A markup ratio of 4.88x means for every $100 Medicare pays, this provider initially charges $488. 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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