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.
Knee Arthroscopy — Multiple
Meniscectomy medial and lateral compartments. Do not report with 29880 or 29881 for same session.
Total Knee Arthroplasty
90-day global period. Postoperative visits bundled unless modifier 24 applies.
Total Hip Arthroplasty
90-day global period. Prior authorization required by most commercial payers.
Closed Treatment Tibial Plateau
Without manipulation. Watch for modifier LT/RT and coordinate with imaging codes 73562.
ORIF Tibial Plateau
Open reduction with internal fixation, unicondylar. 90-day global. Documentation must specify condyle involved.
Unlisted Femur/Knee Procedure
Requires special report with operative details. Often denied — include comparative CPT code justification.
Achilles Tendon Repair — Primary
Acute rupture repair. Watch bundling with 27652 (secondary repair) — cannot bill both same session.
Achilles Tendon Repair — Secondary
Delayed or chronic repair. Requires documentation of prior injury and functional loss.
Gastrocnemius Recession
Strayer procedure. Frequently paired with foot reconstruction — modifier 51 or 59 depending on payer.
Ankle Ligament Repair — Primary
Collateral ligament repair, primary. Include specific ligament (lateral/medial) in documentation.
Tarsal Tunnel Release
Posterior tibial nerve decompression. Requires EMG documentation for medical necessity.
TMT Joint Arthrodesis
Tarsometatarsal fusion. Watch bilateral modifier 50 vs LT/RT — payer specific.
Foot Strapping/Taping
Includes materials. Cannot bill separately with orthotic dispense (L codes) same visit.
Knee Strapping
Application only. Excludes cast application (29405). Documentation must specify strapping method.
Wrist Tenosynovectomy
De Quervain release. First dorsal compartment. Include ICD-10 M65.4 for coverage.
Distal Radius Fracture ORIF
Open reduction with internal fixation. Global period 90 days. Cast application separately billable.
Major Joint Injection
Aspirations and injections of shoulder, knee, hip. Watch bilateral modifier and drug HCPCS billing.
Skeletal Traction Pin Insertion
Includes application of traction. Common in trauma cases — verify inpatient/outpatient POS.
Rotator Cuff Repair — Arthroscopic
Frequently bundled with 29826 subacromial decompression under NCCI edits. Modifier 59 rarely acceptable.
SC Joint Dislocation
Sternoclavicular joint, closed treatment without manipulation. Include imaging correlation (73000).
Elbow Tendon Repair
Distal biceps tendon reinsertion. Requires MRI documentation. Often bundled with 24357 if same tendon.
Carpal Tunnel Release
Open technique. NCCI bundles endoscopic 29848 — do not bill both same wrist.
Cervical Fusion
ACDF single level. 90-day global. Coordinate with 22845 instrumentation and 20936 bone graft when applicable.
Lumbar Fusion — Posterior
Single level. Prior authorization always required. Include failed conservative treatment documentation.
Lumbar Epidural Injection
With imaging guidance. Watch frequency limits — most payers 3-4 per year.
Knee X-Ray
2 views. Bill globally or split professional (26) and technical (TC) components based on POS.
Knee MRI Without Contrast
Prior authorization required by most payers. Include clinical indication and failed conservative treatment.
Excision Thigh Tumor
Subcutaneous, less than 3 cm. Size documentation critical for correct code selection.
Unna Boot Application
Includes materials. Cannot bill more than once every 2 weeks per payer guidelines.
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.