This provider's $5.6M 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 | $703.74 | $191.15 | 3.68x | $512.59 | $590.7K | 8.6K | 5.4K |
| 2015 | $722.59 | $201.73 | 3.58x | $520.86 | $610.0K | 7.7K | 5.3K |
| 2016 | $801.07 | $227.88 | 3.52x | $573.19 | $578.2K | 7.3K | 5.0K |
| 2017 | $964.19 | $262.33 | 3.68x | $701.86 | $599.8K | 6.8K | 4.7K |
| 2018 | $1.2K | $333.37 | 3.64x | $881.54 | $597.3K | 6.7K | 4.5K |
| 2019 | $873.89 | $240.05 | 3.64x | $633.84 | $523.7K | 6.1K | 4.3K |
| 2020 | $847.92 | $239.61 | 3.54x | $608.31 | $496.5K | 5.1K | 3.6K |
| 2021 | $551.83 | $145.88 | 3.78x | $405.95 | $545.3K | 5.3K | 3.7K |
| 2022 | $632.52 | $163.49 | 3.87x | $469.03 | $500.8K | 4.5K | 3.2K |
| 2023 | $841.85 | $175.92 | 4.79x | $665.93 | $529.6K | 5.0K | 3.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.3K | $1.3M | $1.0K | 3.76x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 967 | $1.0M | $1.0K | 3.64x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 5.9K | $664.8K | $113.13 | 4.18x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 5.4K | $455.9K | $83.86 | 4.94x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.5K | $451.4K | $52.85 | 2.89x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 7.7K | $379.3K | $49.19 | 7.44x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.7K | $282.4K | $76.08 | 2.97x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.0K | $219.0K | $72.72 | 3.20x |
| 27487 | Revision of lower thigh bone and both shin bone components of total knee joint prosthesis | 104 | $137.8K | $1.3K | 3.35x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 3.5K | $107.1K | $30.57 | 3.66x |
| 73565 | X-ray of both knees, standing, front to back view | 4.3K | $106.7K | $24.55 | 3.73x |
| 73560 | X-ray of knee, 1 or 2 views | 4.4K | $96.0K | $21.78 | 3.83x |
| 27134 | Revision of thigh bone and hip joint prosthesis | 45 | $57.4K | $1.3K | 3.78x |
| 73562 | X-ray of knee, 3 views | 1.9K | $53.0K | $28.22 | 3.37x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 695 | $36.4K | $52.40 | 7.82x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 6.9K | $28.5K | $4.12 | 3.31x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 253 | $28.0K | $110.80 | 4.02x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 767 | $20.5K | $26.79 | 3.40x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 182 | $20.4K | $111.92 | 2.87x |
| 73564 | X-ray of knee, 4 or more views | 644 | $19.8K | $30.80 | 5.00x |
This provider submits charges 4.02 times higher than what Medicare actually pays.
A markup ratio of 4.02x means for every $100 Medicare pays, this provider initially charges $402. 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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