This provider's $4.0M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Medicare payments to this provider grew 106% from 2014 to 2023.
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 | $665.64 | $200.30 | 3.32x | $465.34 | $276.5K | 4.0K | 2.6K |
| 2015 | $774.76 | $232.12 | 3.34x | $542.64 | $290.0K | 4.1K | 2.7K |
| 2016 | $702.09 | $207.12 | 3.39x | $494.97 | $277.5K | 4.4K | 2.9K |
| 2017 | $614.85 | $188.89 | 3.26x | $425.96 | $347.4K | 5.6K | 3.8K |
| 2018 | $614.36 | $187.25 | 3.28x | $427.11 | $407.1K | 6.9K | 4.2K |
| 2019 | $683.84 | $205.42 | 3.33x | $478.42 | $444.7K | 7.8K | 4.7K |
| 2020 | $703.39 | $222.80 | 3.16x | $480.59 | $399.5K | 6.4K | 4.0K |
| 2021 | $676.59 | $206.14 | 3.28x | $470.45 | $478.7K | 7.1K | 4.5K |
| 2022 | $649.32 | $200.90 | 3.23x | $448.42 | $539.7K | 8.3K | 5.2K |
| 2023 | $634.01 | $199.57 | 3.18x | $434.44 | $570.9K | 8.6K | 5.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 13.5K | $728.5K | $53.97 | 1.76x |
| 27447 | Repair of knee joint | 703 | $690.7K | $982.56 | 2.92x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 10.2K | $479.8K | $47.21 | 3.45x |
| 23472 | Prosthetic repair of shoulder joint | 356 | $386.1K | $1.1K | 2.59x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.0K | $230.9K | $77.84 | 1.87x |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 276 | $218.4K | $791.28 | 2.54x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 2.4K | $160.3K | $66.47 | 3.20x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.2K | $145.3K | $66.20 | 2.19x |
| 29828 | Release of shoulder biceps tendon using an endoscope | 323 | $138.8K | $429.74 | 3.87x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 1.4K | $96.2K | $67.49 | 3.30x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 809 | $86.5K | $106.97 | 2.10x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.1K | $67.6K | $32.15 | 1.87x |
| 29823 | Extensive removal of shoulder joint tissue using an endoscope | 282 | $63.9K | $226.60 | 5.01x |
| 73030 | X-ray of shoulder, minimum of 2 views | 2.8K | $59.7K | $21.24 | 2.88x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 7.3K | $59.0K | $8.03 | 3.76x |
| 73562 | X-ray of knee, 3 views | 1.9K | $50.9K | $27.12 | 2.48x |
| 29826 | Shaving of shoulder bone using an endoscope | 375 | $48.9K | $130.37 | 9.28x |
| 23405 | Incision of shoulder tendon | 150 | $41.9K | $279.33 | 4.08x |
| 73221 | Mri scan of arm joint without contrast | 253 | $38.8K | $153.49 | 3.91x |
| 73565 | X-ray of both knees, standing, front to back view | 1.7K | $38.2K | $22.80 | 2.41x |
This provider submits charges 2.82 times higher than what Medicare actually pays.
A markup ratio of 2.82x means for every $100 Medicare pays, this provider initially charges $282. 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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