This provider's $7.4M in total Medicare payments ranks in the 96th percentile of Ambulatory Surgical Center providers nationally.
Their average markup ratio of 11.66x is significantly above the specialty median of 6.1x.
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 |
|---|---|---|---|---|---|---|---|
| 2022 | $74.9K | $6.3K | 11.86x | $68.5K | $3.2M | 508 | 4 |
| 2023 | $78.3K | $6.8K | 11.50x | $71.5K | $4.2M | 613 | 3 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27130 | Replacement of thigh bone and hip joint with prosthesis | 520 | $3.5M | $6.8K | 12.67x |
| 27447 | Replacement of knee joint, both sides of knee | 404 | $2.7M | $6.7K | 11.38x |
| 27446 | Replacement of knee joint on side of knee | 178 | $1.2M | $6.6K | 9.23x |
| 76000 | Imaging guidance for procedure, 60 minutes or less | 19 | $381.55 | $20.08 | 79.68x |
This provider submits charges 11.66 times higher than what Medicare actually pays.
A markup ratio of 11.66x means for every $100 Medicare pays, this provider initially charges $1166. 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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