This provider's $4.9M 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 | $1.0K | $221.10 | 4.73x | $824.40 | $523.0K | 4.9K | 3.8K |
| 2015 | $1.2K | $272.49 | 4.46x | $941.96 | $613.0K | 5.0K | 4.0K |
| 2016 | $1.0K | $224.45 | 4.57x | $801.43 | $603.8K | 4.9K | 4.0K |
| 2017 | $876.19 | $187.61 | 4.67x | $688.58 | $537.0K | 4.7K | 3.7K |
| 2018 | $1.1K | $233.05 | 4.56x | $828.67 | $475.1K | 4.3K | 3.4K |
| 2019 | $918.37 | $197.16 | 4.66x | $721.21 | $489.8K | 4.5K | 3.6K |
| 2020 | $990.77 | $207.75 | 4.77x | $783.02 | $385.4K | 3.8K | 2.9K |
| 2021 | $847.03 | $201.54 | 4.20x | $645.49 | $503.4K | 3.5K | 2.8K |
| 2022 | $922.40 | $185.95 | 4.96x | $736.45 | $459.1K | 3.6K | 2.9K |
| 2023 | $1.0K | $148.31 | 6.90x | $875.21 | $352.2K | 3.4K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.1K | $1.3M | $1.2K | 4.61x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 831 | $973.6K | $1.2K | 4.39x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.3K | $379.0K | $59.92 | 3.96x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.5K | $313.4K | $89.17 | 4.09x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 3.4K | $242.2K | $71.38 | 4.97x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 282 | $216.1K | $766.39 | 1.63x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 995 | $129.1K | $129.74 | 4.56x |
| 29880 | Removal of both knee cartilages using an endoscope | 249 | $120.6K | $484.19 | 4.68x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 983 | $116.6K | $118.66 | 4.46x |
| 73721 | MRI scan of leg joint | 880 | $116.1K | $131.88 | 11.84x |
| 73564 | X-ray of knee, 4 or more views | 3.3K | $114.3K | $34.42 | 4.36x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.3K | $109.6K | $82.33 | 4.30x |
| 72170 | X-ray of pelvis, 1 or 2 views | 3.7K | $87.5K | $23.46 | 4.16x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 709 | $87.4K | $123.20 | 4.56x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 1.9K | $87.2K | $47.15 | 5.22x |
| 27446 | Repair of knee joint | 84 | $83.1K | $988.87 | 3.79x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.4K | $80.9K | $33.15 | 4.99x |
| 73562 | X-ray of knee, 3 views | 2.5K | $69.4K | $28.05 | 4.66x |
| 27245 | Surgical treatment of broken thigh bone | 54 | $59.2K | $1.1K | 4.09x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 246 | $41.1K | $167.27 | 4.05x |
This provider submits charges 4.63 times higher than what Medicare actually pays.
A markup ratio of 4.63x means for every $100 Medicare pays, this provider initially charges $463. 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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