MedCare Billing Solutions provides expert orthopedic medical billing for orthopedic surgeons, sports medicine physicians, and spine specialists. Our coders understand global periods, implant billing, and the complex modifier rules that define orthopedic reimbursement.
Orthopedic surgery billing is complicated by global surgical periods, implant and hardware billing, complex modifier requirements, and frequent payer bundling disputes. Common costly errors include:
Orthopedic surgeons lose an average of $200,000â$400,000/year in uncollected revenue from global period mismanagement, implant billing errors, and surgical bundling disputes. MedCare specializes in recovering that revenue.
| CPT Code | Procedure | Common Billing Issue |
|---|---|---|
| 27447 | Total knee arthroplasty (TKA) | Missing implant billing; incorrect global period management |
| 27130 | Total hip arthroplasty (THA) | Hardware HCPCS codes not billed; bilateral modifier errors |
| 29827 | Shoulder arthroscopy with rotator cuff repair | Bundled with other shoulder codes incorrectly |
| 29881 | Knee arthroscopy with meniscectomy | Medial + lateral meniscectomy unbundling errors |
| 22612 | Lumbar fusion, posterior (PLIF) | Add-on code 22614 missed; pedicle screw billing errors |
| 63047 | Lumbar laminectomy | Bundling with discectomy codes when separate |
| 25600â25609 | Distal radius fracture treatment | Coding manipulation vs. surgical repair incorrectly |
| 97110 | Physical therapy â therapeutic exercise | Incorrect unit billing; unbundling with manual therapy |
Prior authorization management for all surgical procedures, MRI, CT, and physical therapy. We track auth expiry dates and surgical schedule changes.
CPC-certified coders specializing in musculoskeletal CPT codes, implant billing, global period tracking, and modifier optimization.
We coordinate professional (surgeon) and facility (ASC/hospital) billing to eliminate duplicate billing errors and maximize total reimbursement.
Aggressive appeals for bundling disputes, medical necessity denials, and out-of-network claim rejections. Average appeal success rate: 74%.
We bill and track all implants, hardware, and biologics separately using correct HCPCS codes â a revenue stream most billing companies miss entirely.
Specialty-specific AR follow-up workflows. We escalate high-value surgical claims aggressively and keep your 90+ day AR under control.
Get a free orthopedic billing audit. We'll analyze your current coding, global period management, and implant billing â and show you exactly what you're missing.