This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.82x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 167% 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 | $1.3K | $222.79 | 5.77x | $1.1K | $258.1K | 2.7K | 1.9K |
| 2015 | $1.5K | $267.92 | 5.50x | $1.2K | $335.2K | 3.3K | 2.2K |
| 2016 | $1.4K | $256.88 | 5.52x | $1.2K | $382.0K | 3.6K | 2.4K |
| 2017 | $1.4K | $255.15 | 5.55x | $1.2K | $407.4K | 3.9K | 2.6K |
| 2018 | $1.3K | $242.02 | 5.52x | $1.1K | $472.9K | 4.4K | 3.1K |
| 2019 | $1.4K | $279.75 | 4.89x | $1.1K | $551.3K | 4.7K | 3.5K |
| 2020 | $1.2K | $255.72 | 4.72x | $950.64 | $500.7K | 4.3K | 3.1K |
| 2021 | $1.3K | $274.97 | 4.76x | $1.0K | $597.2K | 4.7K | 3.5K |
| 2022 | $1.2K | $237.27 | 5.20x | $996.91 | $648.1K | 4.9K | 3.6K |
| 2023 | $1.4K | $209.52 | 6.71x | $1.2K | $690.5K | 5.5K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 27447 | Repair of knee joint | 1.1K | $1.4M | $1.3K | 6.18x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.1K | $712.0K | $99.98 | 5.54x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 471 | $624.2K | $1.3K | 5.68x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 7.7K | $490.8K | $63.82 | 7.61x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.4K | $337.9K | $143.24 | 5.64x |
| 73562 | X-ray of knee, 3 views | 7.0K | $302.5K | $43.15 | 5.37x |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | 344 | $204.4K | $594.07 | 3.07x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.7K | $180.9K | $66.42 | 5.94x |
| 20985 | Computer-assisted surgical navigational procedure for bone procedures | 1.1K | $159.6K | $147.91 | 5.13x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 851 | $95.0K | $111.61 | 4.22x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 2.2K | $88.2K | $40.32 | 5.64x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 676 | $62.4K | $92.36 | 5.53x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 2.5K | $22.8K | $9.25 | 4.22x |
| 72170 | X-ray of pelvis, 1 or 2 views | 799 | $21.5K | $26.93 | 5.91x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 148 | $18.3K | $123.67 | 4.89x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 3.8K | $15.9K | $4.14 | 4.04x |
| 73510 | X-ray of ribs of one side of body, minimum of 2 views | 440 | $15.7K | $35.66 | 5.49x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 71 | $11.9K | $168.08 | 6.74x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 127 | $10.5K | $82.31 | 5.01x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 41 | $8.4K | $203.92 | 6.65x |
This provider submits charges 5.82 times higher than what Medicare actually pays.
A markup ratio of 5.82x means for every $100 Medicare pays, this provider initially charges $582. 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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