Global Period Management
Most orthopedic surgeries carry 90-day global periods that bundle follow-up visits into the surgical fee. Billing separately during the global period without proper modifiers (24, 58, 78, 79) results in automatic denials.
Orthopedic Billing Experts
Orthopedic Medical Billing Services
Revenue cycle management for orthopedic practices handling surgical coding, implant billing, and global period tracking.
300+
Ortho Practices Served
97.8%
First-Pass Rate
$5.1M
Revenue Recovered
48hr
Surgical Claims
Overview
The Complexity of Orthopedic Billing
Orthopedic billing involves some of the most complex coding in medicine. Surgical procedures carry global periods that restrict follow-up billing. Implant costs must be tracked and billed separately. And modifier usage for bilateral procedures, co-surgeons, and staged surgeries can make or break reimbursement.
We bring orthopedic-specific coding expertise to every claim. Our team understands CPT surgical hierarchies, global period rules, and the modifier combinations that maximize reimbursement while staying fully compliant.
Challenges
Common Orthopedics billing Challenges We Solve
Every Orthopedics billing team deals with payer delays, coding nuance, and collection leakage. We tighten those weak points before they turn into write-offs.
Implant and Hardware Billing
Implant costs for joint replacements, spinal hardware, and fracture fixation devices must be billed correctly using HCPCS codes. Underbilling or failing to bill implants separately from facility fees leaves significant revenue uncollected.
Modifier Complexity for Surgical Cases
Bilateral procedures (modifier 50), co-surgeon arrangements (62), assistant surgeon (80, 82), and staged procedures (58) each follow different payer rules. Incorrect modifier combinations cause denials or reduced payments.
Pre-Authorization for Surgical Procedures
Most payers require prior authorization for orthopedic surgeries, especially joint replacements, spinal fusions, and arthroscopic procedures. Missing authorization means zero reimbursement regardless of clinical necessity.
Services
Complete Orthopedics billing Services
Support spans the full revenue cycle, from front-end verification to denial recovery and reporting.
Surgical CPT coding with global period tracking
Implant and hardware charge capture and HCPCS billing
Modifier management for bilateral, staged, and co-surgery cases
Prior authorization for surgical and imaging procedures
Workers' compensation and personal injury billing
ASC and hospital outpatient facility billing coordination
Coverage
Serving Orthopedics billing Teams Nationwide
We support independent practices, multisite groups, and growing provider organizations with flexible workflows.
Independent physician groups
Multi-location practices
Private equity backed platforms
Hospital-owned outpatient groups
Guide
The Complete Guide to Orthopedics billing
Orthopedic billing involves some of the most complex coding in medicine. Surgical procedures carry global periods that restrict follow-up billing. Implant costs must be tracked and billed separately. And modifier usage for bilateral procedures, co-surgeons, and staged surgeries can make or break reimbursement.
We bring orthopedic-specific coding expertise to every claim. Our team understands CPT surgical hierarchies, global period rules, and the modifier combinations that maximize reimbursement while staying fully compliant.
Common Questions
Frequently Asked Questions About Orthopedics billing
Answers to the questions practice owners and managers ask most often before switching billing partners.
How do you handle orthopedic global period billing?
We track the 10-day and 90-day global periods for every surgical case. When a post-op visit falls within the global period but addresses an unrelated problem, we apply modifier 24 with supporting documentation. For complications requiring return to the OR, we use modifier 78 or 79 as appropriate.
Can you bill for orthopedic implants separately?
Yes. We track implant costs by case, apply the correct HCPCS codes, and bill implants separately from the surgical procedure code. For ASC cases, implant pass-through billing follows CMS guidelines, and we reconcile invoice costs against reimbursement.
What is the most common reason orthopedic claims get denied?
The top denial reasons are missing prior authorization (especially for MRIs, joint replacements, and spinal procedures), incorrect modifier usage on bilateral or staged procedures, and documentation that does not support the complexity level billed.
Do you handle workers' comp billing for orthopedic practices?
Yes. Orthopedic workers' comp billing requires state-specific fee schedules, employer authorization tracking, impairment rating documentation, and regular progress reports to adjusters. We manage the entire process.
How do you manage billing for multi-location orthopedic groups?
We provide centralized billing with location-level reporting, surgeon-level productivity dashboards, and standardized coding protocols across all sites. This ensures consistency while allowing each location to track its own performance.
What is your turnaround time for orthopedic surgical claims?
Surgical claims are submitted within 48 hours of receiving the operative report and supporting documentation. For straightforward office visits, turnaround is 24 hours. Faster submission accelerates cash flow.
Comparison
How We Compare for Orthopedics billing
The difference is operational discipline. We focus on clean submissions, fast follow-up, and transparency.
Criteria
My Medical Bill Solution
Typical Provider
Specialty-specific billing workflows
Included
Often generic
Dedicated account ownership
Yes
Shared queue
Denial root-cause reporting
Weekly
Ad hoc
Claim submission speed
Within 24 hours
Varies
Communication cadence
Planned check-ins
Reactive only
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