Billing built for orthopedic practices, not generic medical.
Certified coders who understand the difference between a 29881 and a 29888. Ortho practices lose more revenue to modifier errors and global period misuse than any other specialty. We specialize in getting it right: surgical coding, DME billing, sports medicine, and total joint replacements. Same 4.99% flat rate.
Orthopedic CPT codes we handle every day.
Modifier 59 and 51 rules trip up most general billers. Our ortho coders know exactly when to append and when to leave alone.
Knee Arthroscopy
Meniscectomy with debridement. Modifier 59 needed when combined with other knee procedures.
Total Knee Arthroplasty
90-day global period. Postoperative visits bundled unless modifier 24 applies.
Major Joint Injection
Aspirations and injections of shoulder, knee, hip. Watch bilateral modifier and drug HCPCS billing.
Total Hip Arthroplasty
90-day global period. Prior authorization required by most commercial payers.
Rotator Cuff Repair
Arthroscopic. Frequently bundled with 29826 subacromial decompression under NCCI edits.
Distal Radius Fracture
ORIF with internal fixation. Global period 90 days. Cast application separately billable.
Where orthopedic billing usually breaks.
Three patterns account for most denials in orthopedics. Our specialized coders catch these before submission.
Medical Necessity
Conservative treatment documentation missing before surgery. Common on arthroscopy and joint replacement claims.
Modifier 59 Errors
Missing or misapplied modifier 59 on distinct procedural services. Most common with arthroscopy combos and injections.
Prior Authorization
Missing prior auth on joint replacements, MRI, and DME. Requirements vary by payer and procedure.
Each ortho sub-specialty billed differently. We handle all of them.
Coders matched to your sub-specialty. Sports medicine billing looks nothing like joint replacement billing, and hand surgery has its own rulebook.
Joint Replacement
Total knee, hip, shoulder replacements. 90-day global periods, DRG considerations for inpatient, ASC billing for outpatient.
Sports Medicine
ACL reconstruction, meniscus repair, shoulder scopes. High modifier 59 usage, careful bundling of scope + repair combos.
Spine Surgery
Discectomy, laminectomy, spinal fusion. Complex multi-level coding, modifier 62 for co-surgeons, add-on codes stacking.
Hand & Upper Extremity
Carpal tunnel, trigger finger, distal radius. Small procedure codes with strict laterality modifiers (RT/LT/50).
Foot & Ankle
Bunion correction, hammertoe, achilles repair. Podiatry-adjacent but under orthopedic billing rules.
DME & Bracing
Knee braces, walking boots, cold therapy. HCPCS Level II coding, PA requirements, and supplier fee schedules.
See what better ortho coding could recover.
Pick your top surgery and monthly volume. We’ll show you what most ortho practices leave on the table with modifier errors, and what CureMed typically recovers.
Estimates based on average commercial payer reimbursement rates and typical modifier-error recovery patterns across CureMed clients. Your actual numbers will depend on payer mix and current coding accuracy.
Full-service orthopedic billing.
Everything an orthopedic practice needs, from surgery scheduling to final payment posting and appeals.
Surgical Coding
Arthroscopy, joint replacements, spine, hand, foot procedures with correct modifiers.
DME Billing
Braces, boots, cold therapy units. HCPCS Level II coding with proper documentation.
Global Period Tracking
90-day post-op windows managed. Modifier 24 and 79 applied when needed.
Prior Auth Management
Every surgery, MRI, and DME item pre-authorized before scheduling.
Denial Appeals
Ortho-specific denial patterns worked with proper documentation and payer escalation.
Dedicated Manager
Same person answers when you have modifier questions or need a denial appeal filed.
“We’re a four-surgeon ortho group and our previous billing team just didn’t know ortho. They kept missing modifier 59 on scope combos and DME claims were getting written off after 60 days. CureMed picked up an extra $60K a month in the first quarter just by coding correctly.”
Common questions about orthopedic billing.
What is orthopedic billing?
Orthopedic billing covers the coding and submission of claims for musculoskeletal services including joint replacements, arthroscopy, fracture care, sports injuries, and DME. It requires specialized knowledge of surgical modifiers, global periods, and complex bundling rules.
What CPT codes are common in orthopedic billing?
Common orthopedic CPT codes include 29881 (knee arthroscopy), 27447 (total knee arthroplasty), 20610 (joint injection), 27130 (total hip arthroplasty), and 29827 (rotator cuff repair). Each has specific modifier and documentation requirements.
Why do orthopedic claims get denied?
Top reasons include medical necessity documentation gaps (34%), missing modifier 59 for distinct procedures (26%), and prior authorization issues (19%). Global period misuse is another common denial trigger.
Do you handle DME billing?
Yes. DME billing (knee braces, walking boots, cold therapy, home traction) is a major revenue channel for most ortho practices and often the most under-billed. We handle HCPCS Level II coding and PA requirements.
How do you handle global periods?
We track every 90-day and 10-day global period per procedure per patient. Modifier 24 (unrelated E/M) and 79 (unrelated procedure) are applied when appropriate so you don’t miss legitimate reimbursement during global windows.
Ready for billing that actually speaks orthopedics?
Send us three months of your surgical claims and denials. We’ll deliver a free ortho-specific audit within a week showing exactly where your revenue is slipping.