This provider's $4.5M 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 | $132.74 | $45.86 | 2.89x | $86.88 | $412.6K | 6.5K | 3.2K |
| 2015 | $135.40 | $41.82 | 3.24x | $93.58 | $494.5K | 8.0K | 3.9K |
| 2016 | $137.36 | $41.78 | 3.29x | $95.58 | $479.8K | 8.2K | 4.1K |
| 2017 | $160.31 | $49.27 | 3.25x | $111.04 | $443.7K | 7.9K | 3.9K |
| 2018 | $291.74 | $96.84 | 3.01x | $194.90 | $395.0K | 6.9K | 3.7K |
| 2019 | $258.82 | $108.47 | 2.39x | $150.35 | $592.3K | 8.8K | 4.7K |
| 2020 | $269.93 | $90.41 | 2.99x | $179.52 | $402.9K | 6.5K | 3.9K |
| 2021 | $303.18 | $137.35 | 2.21x | $165.83 | $522.5K | 7.0K | 4.0K |
| 2022 | $385.05 | $87.31 | 4.41x | $297.74 | $390.3K | 6.1K | 3.5K |
| 2023 | $508.13 | $95.28 | 5.33x | $412.85 | $375.8K | 7.0K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 20610 | Aspiration and/or injection of large joint or joint capsule | 25.0K | $1.5M | $60.06 | 5.73x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 9.6K | $1.2M | $128.83 | 2.83x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.7K | $599.0K | $55.80 | 2.47x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.3K | $313.0K | $95.79 | 4.20x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 379 | $232.9K | $614.62 | 2.69x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.1K | $164.3K | $77.11 | 2.96x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 1.1K | $128.9K | $115.54 | 3.22x |
| 73562 | X-ray of knee, 3 views | 2.8K | $86.7K | $30.61 | 3.16x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 582 | $73.7K | $126.57 | 5.49x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 90 | $47.5K | $528.15 | 3.92x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.4K | $35.8K | $26.00 | 4.39x |
| 73501 | X-ray of hip with pelvis, 1 view | 766 | $19.5K | $25.43 | 3.98x |
| 73564 | X-ray of knee, 4 or more views | 411 | $16.0K | $38.85 | 4.75x |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 12.6K | $14.6K | $1.16 | 2.89x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 151 | $7.2K | $47.91 | 7.73x |
| J7329 | Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg | 862 | $6.6K | $7.71 | 3.84x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 159 | $4.8K | $30.15 | 3.65x |
| 72170 | X-ray of pelvis, 1 or 2 views | 159 | $3.6K | $22.55 | 4.05x |
| 73080 | X-ray of elbow, minimum of 3 views | 124 | $3.2K | $26.17 | 4.39x |
| 20552 | Injection of trigger points, 1-2 muscles | 75 | $3.2K | $43.16 | 6.86x |
This provider submits charges 3.95 times higher than what Medicare actually pays.
A markup ratio of 3.95x means for every $100 Medicare pays, this provider initially charges $395. 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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