Orthopedic Billing Services
An orthopedic practice does not run one billing operation, it runs three, and they follow different rulebooks. The surgeon's fee is paid under the physician fee schedule. The facility fee, where the group owns an ambulatory surgery centre, is paid under the ASC payment system, which folds most of what the surgeon thinks of as the implant into the procedure rate instead of paying it on an invoice. Braces, orthotics and other take-home devices are neither — federal regulation excludes non-implantable prosthetic devices and DME from ASC services outright, so they leave as a separate DMEPOS claim under their own documentation rules. Treating the three as one workflow is the structural error behind most orthopedic write-offs, and taking it apart is the first thing we do. We run all three streams and reconcile them against each other, because the seams are where the money goes missing: an implant billed on a manufacturer invoice when Medicare had already packaged it into the facility payment, a brace assumed into a fee that regulation says does not cover it, a post-operative visit written off inside the ninety-day global period when the right modifier would have made it separately payable, a workers' compensation claim that died at the jurisdiction and never appeared in the denial report at all. We code arthroscopy from what the primary codes already contain rather than by stacking add-ons — chondroplasty inside the knee meniscectomy codes, limited debridement inside the shoulder codes — and price multi-procedure cases on the endoscopic-family rules CMS assigns them rather than the standard reduction. We make the fracture-care election an explicit decision in the record: whether the practice is managing the fracture through healing or providing the initial care alone. And we keep workers' compensation in state-specific workflows, with the fee schedule, review window and attachment rules loaded per jurisdiction. We work with orthopedic groups that own an ASC, surgeons dispensing bracing and orthotics in the office, and practices carrying heavy workers'-compensation volume.
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What Is Orthopedic Billing?
Orthopedic billing is three claim streams run against three rulebooks, and we keep them separate on purpose. The professional claim. The surgeon's work under the physician fee schedule — arthroscopy, arthroplasty, fracture care — to which CMS's CY2026 relative value file assigns a 090-day global period on the major procedures, so we screen every encounter inside that window for the modifier that makes it separately payable instead of letting it be written off. 42 CFR 416.164(c)(1) places physicians' services outside ASC services, so this claim stands on its own whoever owns the facility. The ASC facility claim. Under 42 CFR 416.164(a)(8), implanted prosthetic devices “not on pass-through status” are packaged into the ASC payment. The exceptions are defined: under 42 CFR 416.171(b) the device portion of device-intensive procedures — those with “a HCPCS code-level device offset of greater than 30 percent” — is paid an amount derived from the OPPS rate and is contractor-priced where no rate is available, and 416.164(b)(2) allows separate payment for items holding pass-through status under the OPPS. There is no general Medicare rule that an implant is paid on a manufacturer invoice; invoice pricing is a commercial-contract and workers'-compensation arrangement, so we establish which of the three regimes applies to a case before it is posted rather than after it is denied. The DME claim. 42 CFR 416.164(c) excludes “[l]eg, arm, back, and neck braces other than those that serve the function of a cast or splint” and “[n]onimplantable prosthetic devices and DME” from ASC services, so we bill these as DMEPOS with their own face-to-face documentation and supplier requirements. One number moves all of it this year: the Medicare conversion factor is $33.4009 for clinicians who are not qualifying APM participants and $33.5675 for those who are, up from $32.3465 in CY2025 — a change that resets every orthopedic allowable and quietly underprices any expected-pay table still carrying last year's figure. The code table further down this page shows the CY2026 Medicare national unadjusted non-facility amount — total RVU from that relative value file multiplied by the non-qualifying-APM conversion factor — not an average across payers and not a quote. Your own contracted rates will differ, and a code Medicare does not cover is shown blank.
- ASC implants are packaged unless device-intensive or on OPPS pass-through (42 CFR 416.164/.171)
- Professional, ASC facility and DMEPOS are three claims with three rulebooks
- Knee 29881 (medial OR lateral) vs 29880 (medial AND lateral) — both already include chondroplasty
- Fracture codes include the initial cast/splint; the cast code is billable only for initial care alone
Who This Page Is For
Common Billing Friction in Orthopedic
Shoulder arthroscopy: what the primary code already includes
Shoulder arthroscopy bundles more than most coders expect. The 2026 NCCI Policy Manual, chapter IV, states that “[s]urgical arthroscopy includes diagnostic arthroscopy which is not separately reportable,” that “[s]houlder arthroscopy procedures include limited debridement (e.g., CPT code 29822) even if the limited debridement is performed in a different area of the same shoulder,” and that with three exceptions the same is true of extensive debridement (29823) — the exceptions being 29824, 29827 and 29828, which “may be reported separately with CPT code 29823 if the extensive debridement is performed in a different area of the same shoulder.” It also states that where an arthroscopic procedure is converted to an open one, “only the open procedure may be reported.” Subacromial decompression (29826) is an add-on: CMS's CY2026 relative value file gives it global indicator ZZZ, meaning it is “related to another service and is always included in the global period of the other service,” so it bills only alongside a primary scope. CMS publishes the pair-level PTP edit table under an AMA licence and it is not freely retrievable, so we work from the policy manual and the operative report rather than quoting pair-level edits we cannot show you. We do not publish a per-case dollar figure for this; the exposure depends on the code combination and the contract.
Knee arthroscopy: 29881 versus 29880, and why chondroplasty is not an add-on
The 2026 NCCI Policy Manual, chapter IV, sets out both codes in full: 29880 is meniscectomy “(medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty) same or separate compartment(s), when performed,” and 29881 is the same description with “(medial OR lateral …).” Two things follow. First, defaulting to 29881 on every knee scope under-bills the cases where the note actually documents both compartments, and billing 29880 where the dictation names only one invites a downcode. Second — and this is the part usually got wrong — chondroplasty is inside both descriptors, so 29877 is not a separately reportable add-on to them; NCCI states that 29877 “shall not be reported with other knee arthroscopy codes (29866-29889).” The multiple-procedure arithmetic is also not the standard one. CMS's CY2026 relative value file assigns 29880, 29881, 29877, 29827 and 29806 multiple-procedure indicator 3, which the file's own documentation defines as “[s]pecial rules for multiple endoscopic procedures apply if procedure is billed with another endoscopy in the same family,” priced against the family's base procedure — not the 100%/50% reduction that indicator 2 carries. Expected-pay models built on the 100/50 rule misprice these cases in both directions.
Fracture care: treating the episode versus taking over care
Distal radius fracture offers four pathways — 25600 closed without manipulation, 25605 closed with manipulation, 25608 open treatment of two fragments, 25609 of three or more — and CMS's CY2026 relative value file gives all four a 090-day global period, so electing a fracture-care code commits the practice to ninety days of included follow-up. What that global period contains is specified. The 2026 NCCI Policy Manual, chapter IV, states that “[f]racture and dislocation CPT codes include the initial casting, strapping, or splinting,” that codes for closed, percutaneous or open treatment “include the application of casts, splints, or strapping” which “shall not be reported separately,” and that a physician who applies the initial cast “and also assumes the follow-up care … cannot report the casting/splinting/strapping CPT codes.” The alternative pathway is described just as precisely: where a physician treats the injury with a cast, splint or strap “as an initial service without any other definitive procedure or treatment and only expects to perform the initial care,” the provider “may report an E&M service, a casting/splinting/strapping CPT code, and a cast/splint/strap supply code (Q4001-Q4051).” So the choice is not a billing preference. It is a statement about who is managing the fracture through healing, and the record has to say which one happened.
ASC implants: packaged by default, separately paid only in defined cases
The widely repeated rule — bill the implant on L8699 with the manufacturer invoice attached — is not the Medicare rule, and a group that builds its ASC pro forma on it will be wrong about the money. Under 42 CFR 416.164(a)(8), implanted prosthetic devices and related accessories “not on pass-through status” are packaged into the ASC payment for the surgical procedure. The regulation names two defined exceptions. 42 CFR 416.164(b)(2) allows separate payment for “[c]ertain implantable items that have pass-through status under the OPPS.” And under 42 CFR 416.171(b)(2) the device portion of device-intensive procedures is paid an amount derived from the OPPS payment rate for the equivalent item or service, and is contractor-priced where no rate is available — procedures that involve an implantable device with its own HCPCS code, that must be surgically inserted or implanted, and that have “a HCPCS code-level device offset of greater than 30 percent when calculated according to the standard OPPS ASC ratesetting methodology.” CMS publishes which procedures qualify; it is a list, not a judgement call. Invoice-based implant payment does exist — in commercial contracts that carve implants out and in most state workers'-compensation fee schedules — but it is a term of that contract, not a general entitlement, and the answer is different payer by payer and sometimes procedure by procedure. The billing work is therefore to know, per case, which of the three regimes applies before the case is posted. We do not publish an annual recoverable-revenue figure for this, because the correct figure for a given ASC depends on its payer mix and its contracts. (42 CFR 416.164 and 416.171 as in force 15 September 2026; verified 17 September 2026.) The conversion factors, global periods, bundling rules and ASC payment rules quoted across this page were verified against CMS's CY2026 physician fee schedule relative value file, the 2026 NCCI Policy Manual and the current text of 42 CFR part 416 on 17 September 2026.
DMEPOS: a separate claim, because the ASC payment does not cover it
42 CFR 416.164(c) puts this beyond argument: ASC services exclude “[l]eg, arm, back, and neck braces other than those that serve the function of a cast or splint,” “[a]rtificial limbs” and “[n]onimplantable prosthetic devices and DME.” A brace dispensed on the day of surgery is therefore not paid by the facility fee and not paid by the professional fee — it is a DMEPOS claim or it is unpaid. That claim carries its own requirements: a documented face-to-face encounter within the window CMS specifies before the order, a medical record showing the specific functional limitation the device addresses rather than a diagnosis alone, correct custom-fitted versus off-the-shelf coding with the substantial modification documented at delivery, and, for a practice dispensing in-office, supplier accreditation and a DMEPOS supplier number. Practices that dispense without the accreditation in place discover it at the first audit rather than the first claim.
Workers' compensation: a parallel rulebook per state
Workers' comp claims pay off each state's WC fee schedule — not billed charges and not the Medicare PFS — with their own authorization timelines, first-report-of-injury documentation, and e-billing attachment standards. A practice that runs WC claims through its commercial workflow accumulates silent denials that never surface as payer rejections, because the claim dies at the jurisdiction level. We segregate WC claims into state-specific workflows with the fee schedule, UR window, and attachment rules loaded per jurisdiction.
Orthopedic-Specific Payer Issues We Watch For
Bilateral procedures
Issue: CMS's CY2026 relative value file assigns bilateral surgery indicator 1 to the major joint and arthroscopy codes, meaning the 150% bilateral payment adjustment applies, but commercial bilateral reduction terms are contractual and some plans apply a deeper reduction to the second side than the contract provides for
Our approach: We check the bilateral indicator CMS publishes per code, compare the paid amount against the contracted bilateral term rather than against an assumption, and appeal underpayments with the contract language attached.
Medicare
Issue: 90-day global surgical period includes all follow-up care related to the surgery — billing E/M visits during the global period without modifier 24 for an unrelated condition results in denial
Our approach: We track global surgical periods for every orthopedic procedure and apply modifier 24 for unrelated conditions or modifier 58 for staged procedures during the global period
Joint replacement prior authorization
Issue: Many plans require prior authorization for joint replacement and ask for conservative-treatment documentation in the request; criteria vary by plan and contract
Our approach: We compile prior authorization packages with documented conservative treatment history, diagnostic imaging, and functional limitation assessments per the plan's criteria
Fracture care with same-day E/M
Issue: Payers can bundle the fracture management code into the same-day E/M, denying the fracture care code when both are billed for one encounter — which is correct in some cases and not in others, because NCCI treats the decision to perform a minor procedure as included in it
Our approach: We separate the encounters that genuinely carry a significant, separately identifiable E/M from those where the visit was the decision to treat the fracture, and append modifier 25 only to the former. Per the 2026 NCCI Policy Manual the two services do not need different diagnoses — but the E/M must be unrelated to the decision to perform the procedure.
What We Handle
Arthroscopic surgical coding (CPT 29800 series)
Coding for knee arthroscopy (29881, 29880) and shoulder arthroscopy (29827, 29826 as an add-on, 29806) built on what the primary codes already include — diagnostic arthroscopy, chondroplasty in the knee meniscectomy codes, limited debridement in the shoulder — rather than on stacking. Multiple-procedure pricing uses the endoscopic-family rules CMS assigns these codes, not the standard 100/50 reduction.
Open joint and arthroplasty coding (CPT 27130-27447)
Total knee (27447), total hip (27130), unicompartmental and patellofemoral replacement, and revision pathways, billed as the professional claim only — 42 CFR 416.164(c)(1) excludes physicians' services from ASC services, so the surgeon's fee and the facility fee are separate claims with separate rules. Includes assistant-surgeon billing with modifiers 80, 81, 82 and AS for PA-assisted cases, checked against the assistant-at-surgery indicator CMS publishes per code.
DMEPOS billing as its own claim stream
Bracing, custom orthotics, crutches and immobilisers billed as DMEPOS rather than assumed into a facility or professional fee, per the 42 CFR 416.164(c) exclusion. Face-to-face encounter documentation, functional-limitation language in the note rather than a bare diagnosis, custom-fitted versus off-the-shelf coding, and the supplier accreditation workflow for in-office dispensing.
Fracture care coding and global-period tracking
Initial fracture care with 090-day global tracking, and the casting and splinting rules that go with it: the cast is included when the practice is managing the fracture, and separately reportable with an E/M and a Q-code supply only where the practice provides the initial care alone and does not assume follow-up. Every post-op encounter inside the global is screened for modifier 24, 58, 78 or 79 before it is written off.
Sports medicine and regenerative procedures
PRP injection (CPT 0232T category III) coverage tracking by payer policy, concussion evaluation coding (96125 cognitive testing, 92540 vestibular battery), and the documentation gates that prevent the routine denials these codes draw. Includes payer-specific protocols where coverage is conditional.
Imaging and modifier discipline (CPT 73221, 73721)
Shoulder MRI (73221), knee MRI (73721), and the technical/professional component split for in-office MRI suites. Modifier 24, 25, 58, 78, and 79 application during the 90-day global period to recover billable post-op encounters that would otherwise be written off.
Spinal surgery and fusion coding
Anterior and posterior fusion coding across CPT 22551-22614, instrumentation add-on codes, bone-graft coding, and co-surgeon modifier 62 splits — the highest-dollar orthopedic claims, where a missed add-on or wrong approach code forfeits four figures per case.
Workers' compensation billing
State-specific workers'-compensation fee schedules, utilisation-review and authorisation timelines, coordination rules and the e-billing and attachment requirements state funds enforce. Many orthopedic practices carry workers'-comp volume, and a WC claim run through a commercial workflow dies at the jurisdiction rather than coming back as a payer denial — so it never shows up in the denial report.
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Key Orthopedic CPT Codes
| CPT Code | Description | Medicare Amount CY2026 national, non-facility |
|---|---|---|
| 27447 | Total knee arthroplasty | $1,159 |
| 27130 | Total hip arthroplasty | $1,162 |
| 29881 | Knee arthroscopy, meniscectomy, medial OR lateral (includes chondroplasty) | $516 |
| 29827 | Shoulder arthroscopy with rotator cuff repair | $976 |
| 20610 | Arthrocentesis, major joint, without ultrasound guidance | $69 |
| 20680 | Hardware removal, deep | $632 |
| 29826 | Shoulder arthroscopy, decompression — add-on code (ZZZ), bills with a primary scope | $148 |
| 28296 | Bunionectomy with osteotomy | $883 |
Amounts are the Medicare national unadjusted non-facility amounts for CY2026, computed from the published CMS relative value file. They are not what a commercial payer pays, and your locality adjustment moves them. A dash means Medicare publishes no amount for that code — because it is non-covered, bundled, or priced outside the fee schedule.
Why General Billing Teams Miss Orthopedic Issues
General billing staff handle dozens of specialties and rarely develop the depth needed for orthopedic coding nuances. Here is what gets missed.
Modifier and bundling errors
Specialty-specific modifier rules and CCI edits are frequently overlooked by teams that do not work exclusively in orthopedic.
Under-coding high-complexity visits
Orthopedic encounters often qualify for higher-level E/M codes, but generalist billers default to mid-level codes to avoid audit risk.
Missed payer-specific rules
Each payer has unique coverage and documentation requirements for orthopedic procedures that general teams rarely memorize.
Slow denial turnaround
Without specialty knowledge, appeal letters lack the clinical specificity needed to overturn orthopedic denials quickly.
“Orthopedic groups think of themselves as running one billing operation. They are running three — the surgeon's professional claim, the ASC facility claim, and DMEPOS — and the losses are almost never inside any one of them. They are at the seams: the implant everyone assumed was invoice-billable when Medicare had packaged it, the brace assumed into a facility fee that regulation explicitly excludes, the post-op visit written off for a missing modifier. Reconcile the three streams against each other and the leaks are visible in a month.”
MedPrecision Billing Team
Orthopedic Surgery Coding Specialist
Transition Plan
Switching billing partners should not disrupt patient care or cash flow. Our transition plan is designed for zero downtime.
Discovery and Specialty Audit
We review your current orthopedic billing workflows, denial patterns, and payer mix to build a tailored onboarding plan.
System Integration
We connect to your EHR and practice management system, configure specialty-specific code sets, and validate charge capture workflows.
Parallel Billing Period
We run billing in parallel with your current process for 2-4 weeks to verify accuracy before taking over completely.
Full Transition and Reporting
Once validated, we assume full billing responsibility with monthly reporting dashboards and a dedicated account manager.
Orthopedic Billing Terms
- Global Surgical Period
- The post-operative period during which follow-up care related to the surgery is included in the procedure's payment. CMS publishes the length per code in the global-days field of its relative value file; the major orthopedic procedures carry 090. 42 CFR 414.40(b)(1) is the regulatory authority for the policy. Encounters inside the window need modifier 24, 58, 78 or 79 to be separately payable.
- Implant Payment in an ASC
- Not a single rule. Under 42 CFR 416.164(a)(8) an implanted prosthetic device without pass-through status is packaged into the Medicare ASC payment for the procedure. The exceptions are items with OPPS pass-through status and device-intensive procedures under 42 CFR 416.171(b)(2) — a device offset above 30 percent — whose device portion is paid an amount derived from the OPPS rate, or is contractor-priced where no rate is available. Invoice-based implant payment is a commercial or workers'-compensation contract term, not a Medicare entitlement.
- Multiple Procedure Reduction
- Payment reduction applied to additional procedures in the same session, governed by the multiple-procedure indicator CMS assigns each code. Indicator 2 carries the standard 100%/50% ranking; indicator 3, which the orthopedic arthroscopy codes carry, applies special rules for multiple endoscopic procedures in the same family priced against that family's base procedure. Using the wrong one misprices the case.
- Fracture Care Coding
- The distinction between providing initial care alone and managing the fracture through healing. Per the 2026 NCCI Policy Manual, fracture treatment codes include the initial casting, strapping or splinting, and a physician who applies the cast and assumes follow-up cannot separately report the casting code; a physician providing only the initial care may report an E/M, a casting code and a Q-code supply.
- Modifier 59 (Distinct Procedural Service)
- Modifiers indicating a distinct procedural service. In orthopedics they are used where two procedures paired by an NCCI edit were genuinely separate — a different anatomic site or a different session — and not as a way past an edit. The pair-level edit table is published by CMS under an AMA licence and is not freely retrievable, so the documentation, not the modifier, is what has to carry the case.
- Bilateral Modifier (50)
- Applied when the same procedure is performed on both sides in one session. CMS publishes a bilateral surgery indicator per code; indicator 1, which the major joint and arthroscopy codes carry, means the 150% bilateral payment adjustment applies. Commercial bilateral reduction terms are contractual and vary, so the paid amount is checked against the contract rather than against the Medicare rule.
Last updated: 2026-10-02
Common Questions
Common questions about orthopedic billing services.
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Request ReviewHow do you handle billing during the 90-day global period?
By tracking it and screening every encounter inside it. 42 CFR 414.40(b)(1) is the authority for Medicare's global surgery policy — it lists “[g]lobal surgery policy (for example, post- and pre-operative periods and services, and intra-operative services)” among the national ancillary policies CMS establishes — but the length per code comes from the global-days field of CMS's CY2026 relative value file, which carries 090 for total knee arthroplasty (27447), total hip (27130), rotator cuff repair (29827) and the distal radius fracture codes 25600, 25605, 25608 and 25609. Inside that window an encounter is payable only with the right modifier: 24 for an unrelated E/M during the post-operative period, 25 for a significant separately identifiable E/M on the same day as a procedure, 58 for a staged or related procedure planned at the time of the original surgery, 78 for an unplanned return to the operating room for a related procedure, 79 for an unrelated procedure. The 2026 NCCI Policy Manual states that post-operative E/M services related to recovery, and to complications of the surgery, are included in the global package, and that visits “unrelated to the diagnosis for which the surgical procedure was performed” may be reported with modifier 24. We have not found a published, verifiable statistic for how often orthopedic post-op E/M is lost to a missing modifier 24, so we do not quote one.
What is the difference between initial fracture care and subsequent fracture care billing?
They are two different commitments, and the record has to show which one the practice made. Initial fracture care uses a fracture treatment code — 25600 for a distal radius fracture treated closed without manipulation, 25605 with manipulation, and so on — and CMS's CY2026 relative value file gives these a 090-day global period covering routine follow-up. The 2026 NCCI Policy Manual states that “[f]racture and dislocation CPT codes include the initial casting, strapping, or splinting,” and that a physician who applies the initial cast “and also assumes the follow-up care … cannot report the casting/splinting/strapping CPT codes.” Initial care without assuming follow-up is coded the other way. The same chapter states that where a physician treats the injury with a cast, splint or strap “as an initial service without any other definitive procedure or treatment and only expects to perform the initial care,” the provider “may report an E&M service, a casting/splinting/strapping CPT code, and a cast/splint/strap supply code (Q4001-Q4051).” A provider taking over management mid-treatment bills their own care rather than re-billing the episode. Miscoding between the two is a recurring denial driver, and payers audit fracture claims for documentation of which pathway was elected.
Do you bill for orthopedic implants and hardware separately?
It depends on the site of service and, for Medicare, the answer is usually no — which is the opposite of what most orthopedic billing guidance says. Medicare, ASC. 42 CFR 416.164(a)(8) packages implanted prosthetic devices “not on pass-through status” into the ASC payment for the procedure. The exceptions are items with OPPS pass-through status under 416.164(b)(2) and device-intensive procedures — 42 CFR 416.171(b)(2) defines those as procedures involving an implantable device with a CPT or HCPCS code, requiring surgical insertion or implantation, and having “a HCPCS code-level device offset of greater than 30 percent.” For those, the device portion is paid an amount derived from the OPPS rate for the equivalent item or service, and is contractor-priced where no rate is available. It is not invoice-priced by default, and L8699 is not a general route to payment. Commercial and workers' compensation. Invoice-based implant carve-outs are real here, and this is where the L8699-plus-invoice workflow actually belongs — but it is a term of the individual contract or the state fee schedule, so the answer differs payer by payer. The professional claim is separate either way. 42 CFR 416.164(c)(1) excludes physicians' services from ASC services, so the surgeon bills the procedure under the physician fee schedule regardless of how the device is paid. The practical work is knowing, per case and per payer, which of those regimes applies before the case is posted. We do not publish an annual recoverable-revenue figure for implant billing, because it depends entirely on case mix and contracts.
What is CPT 29881 and how does it differ from 29880?
Per the 2026 NCCI Policy Manual, 29881 is knee arthroscopy with meniscectomy “(medial OR lateral …) including debridement/shaving of articular cartilage (chondroplasty)” and 29880 is the same “(medial AND lateral …).” Billing 29881 twice for a both-compartment meniscectomy is wrong; 29880 is the single correct code. Note also that chondroplasty is inside both descriptors, so 29877 is not separately reportable with either.
What is the difference between modifier 78 and 79 in the global period?
Modifier 78 is an unplanned return to the operating room for a related procedure during the global period — it does not start a new global period, and Medicare pays the intra-operative portion of the surgical fee, which CMS publishes per code in the intra-operative percentage field of the relative value file rather than as one flat rate. Modifier 79 is an unrelated procedure during the global period, paid in full and starting a new global period. Modifier 58 is for a staged or related procedure planned at the time of the original surgery.
Does outsourcing orthopedic billing make sense for an ASC-owning group?
Often yes, but test it against the specific thing that is leaking rather than the general claim. An ASC-owning group runs three claim streams — the surgeon's professional fee, the ASC facility fee, and DMEPOS — and the money usually goes missing at the seams: an implant treated as invoice-billable when Medicare packages it, a brace assumed into the facility fee when 42 CFR 416.164(c) excludes it, a post-op encounter written off for want of a modifier 24, a workers'-comp claim that died at the jurisdiction and never appeared in the denial report. Those are the four things to check in your own data before you shop. If none of them is happening, in-house is working and you should keep it.
How much do orthopedic billing services cost?
Orthopedic billing prices as a percentage of monthly collections, with surgical volume, ASC ownership and workers'-comp mix setting the workload behind the rate. MedPrecision charges 7.0% of collections for solo practices and 6.0% for groups of 2–15 providers, with no setup fee, no per-claim charge and no software fee, billed on collections received rather than charges submitted; the solo tier carries a minimum monthly fee, set in the quote and service agreement rather than published. Full tiers are on our pricing page.
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