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Specialty Billing

Orthopedic Surgery Billing Services

Orthopedic Surgery Billing & Musculoskeletal Coding

Get a Free Billing Audit 346-307-9057

Specialty Focus

Orthopedic Surgery Billing That Captures What You've Earned

Orthopedic surgery billing involves major joint replacements, complex fracture care, arthroscopic procedures, and a full range of musculoskeletal coding challenges. Global periods, multiple-procedure reduction rules, and implant billing create layered complexity that generalist billers consistently underbill.

Prime Medical Billing's orthopedic billing team handles the full surgical billing lifecycle — operative report coding, global period tracking, implant and hardware billing, post-op visit compliance, and DME billing for braces, splints, and assistive devices. We maximise reimbursement on every surgical episode while keeping your practice audit-ready.

97%
First-Pass Clean Claim Rate
24h
Average Claim Submission
40%
Average A/R Reduction
What We Handle

Key Billing Areas for Orthopedic Surgery Practices

Every billing area below is managed by a specialist trained in your specialty's CPT, ICD-10, and payer requirements.

Joint replacement billing (hip, knee, shoulder)
Arthroscopy procedure coding
Fracture care & casting billing
Modifier 22 & 51 accuracy
Implant & surgical hardware billing
DME & brace billing (L-codes)
Global period tracking
Post-op visit compliance
Electronic remittance posting
Monthly performance reporting
Why Partner With Us

Built for Orthopedic Surgery Billing Complexity

Specialty-Trained Coders

Our billers are trained in your specialty's CPT codes, ICD-10 diagnoses, and payer-specific rules — not generalists working across 50 specialties.

97%+ Clean Claim Rate

We scrub and submit clean claims the first time, reducing rework, accelerating payment, and improving your net collection rate.

24-Hour Denial Recovery

Every denied claim is reviewed within 24 hours, root cause identified, corrected, and re-submitted before payer appeal deadlines close.

Full HIPAA Compliance

Encrypted data handling, a signed Business Associate Agreement, and annual compliance audits — your patients' information is always protected.

Maximize Your Orthopedic Surgery Revenue

Get a free billing audit and find out exactly how much revenue your practice could be recovering. No contracts, no obligation — just results.

Get Your Free Billing Audit Call 346-307-9057

HIPAA Compliant  •  No Long-Term Contracts  •  Results in 30 Days

Common Questions

Orthopedic Surgery Billing — FAQ

Answers to the questions Orthopedic Surgery practices ask us most before partnering with Prime Medical Billing.

Major orthopedic procedures (joint replacements, spinal fusions) have 90-day global periods. We track every surgical global period, monitor post-op visit dates, and bill separately only for services that are unrelated to the surgical condition (modifier 24) or involve complications requiring a return to the OR (modifier 78/79). This protects your practice during audits while ensuring full reimbursement.
Implant billing is one of the most significant revenue streams in orthopedic surgery. Many payers reimburse implants as a separate line item with invoice documentation. We coordinate implant billing between the facility and the surgeon's practice, request implant invoices, and ensure implant cost pass-through is captured where contractually supported.
Fracture care CPT codes (25600–28675 series) include all casting and subsequent visits in the global period. We apply the correct fracture care code based on bone, type (closed vs. open), and manipulation status, coordinate with the facility for closed reduction documentation, and bill cast application (29000 series) only when not included in the fracture care global.
When orthopedic surgeons employ PT staff or bill for therapy services in their own practice, we manage the PT billing with correct CPT codes, therapy caps tracking, and KX modifier documentation for medically necessary care above the cap. For referred-out PT, we ensure the referral is documented to support coordinated care billing.
22 Specialties

We Serve All Medical Specialties

Cardiology Dental Dermatology DME Family Practice Gastroenterology General Surgery Home Health Agency Infectious Disease Internal Medicine Laboratory Mental Health Nephrology Neurology Nursing Home OB/GYN & Women's Health Orthopedic Surgery Pain Management Podiatry Primary Care Rheumatology Urgent Care