Surgical global periods
Major procedures carry global periods during which related care is not separately payable. Unrelated or staged care must be reported with the correct modifier or it is denied as included.
Specialties › Orthopedics
Orthopedic Medical Billing Services
Orthopedics combines high-dollar surgical claims with high-volume office visits, in-house imaging, bracing and often workers' compensation — four billing models in one practice. The revenue risk is concentrated in surgical modifiers and global periods, where a single misapplied modifier can turn a five-figure case into a denial or an audit finding.
What makes it hard
Orthopedics billing challenges we solve
These are the issues that repeat every month in orthopedics practices — and the ones we fix at the source rather than reworking claim by claim.
Modifier accuracy on surgical claims
Same-day decisions for surgery, staged procedures, returns to the operating room and unrelated post-op care each require distinct modifiers. This is where orthopedic revenue is most often lost.
Multiple procedure reductions
When several procedures are performed in one session, payers reduce subsequent procedures. Correct sequencing by value protects reimbursement.
DME, bracing and supplies
In-office bracing and durable medical equipment bill under a separate code set with their own documentation and supplier rules — commonly under-billed or denied outright.
Workers' compensation and third-party liability
Work injuries follow different rules, fee schedules and timelines than commercial insurance, and require far more documentation follow-through.
Coding depth
Common code families we work with
- 29826 / 29881 / 29888 — arthroscopic shoulder and knee procedures
- 27447 / 27130 — total knee and total hip arthroplasty
- 20610 / 20611 — major joint aspiration or injection
- 73000-series — in-office radiology (component rules apply)
- 99202–99215 — office evaluation and management
- L-code series — orthotics, bracing and durable medical equipment
- Modifiers 24 / 25 / 57 / 58 / 78 / 79 — global period and staged care reporting
Listed for context only — this is not billing advice, and payer policy varies. Our certified coders work to AAPC and AHIMA standards.
Denial prevention
Top denial drivers in orthopedics
- Post-operative visit billed within a global period without a modifier
- Missing or incorrect surgical modifier
- Bracing or DME billed without required documentation
- Multiple procedures sequenced incorrectly
- Workers' comp claim missing the required injury or employer information
We root-cause denials by payer and procedure, then fix the upstream workflow so the same denial stops recurring.
Why ERG
What you get with ERG
Specialty-trained billers
Your account is worked by people who bill orthopedics every day — not a general pool learning your rules on your claims.
95%+ net collection rate
Relentless follow-up on every claim, with aged A/R worked rather than written off.
No long-term contract
Performance-based pricing — a percentage of what we collect. Stay because the results are good, not because you are locked in.
5–10 day onboarding
We run parallel with your current process until the transition is verifiably clean.
Human-led, AI-supported
Our certified coders work every claim; AI tools help them catch more before submission.
HIPAA-compliant throughout
Strict PHI controls, access limits and staff training across the whole workflow.
FAQ
Orthopedics billing — common questions
Do you bill orthopedic surgery as well as office visits?
Yes. We bill the full orthopedic practice — surgical cases with their global periods and modifiers, office visits, in-house imaging, injections and bracing — so revenue is not lost between those workflows.
Can you handle workers' compensation claims?
Yes. Workers' comp requires different forms, fee schedules and documentation than commercial insurance, plus persistent follow-up. We manage those claims alongside your commercial book.
Do you bill DME and bracing?
Yes. In-office bracing and DME are commonly under-billed in orthopedics. We bill them with the required documentation so the practice is paid for supplies it has already purchased and dispensed.
Can you clean up our aged surgical A/R?
Yes. Aged surgical claims are usually worth pursuing because of their value per claim. Our A/R analysis identifies what is still recoverable before you write it off.
Client results
What practices say about working with us
★★★★★Credentialing used to stall every new hire for months. They got our providers loaded way faster than promised.
— David T., Office Administrator
★★★★★Our A/R days dropped from 58 to 31 in one quarter. First time in years I actually trust my numbers.
— Sarah M., Practice Manager
Next step
See what your orthopedics practice is leaving uncollected
A no-obligation A/R analysis. We review your aging, denial patterns and coding mix, then show you exactly where the recoverable revenue is.
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