Specialty billing guide
Best Medical Billing Companies for Orthopedics
The short answer
Eight firms state orthopedics billing focus on their own sites, listed alphabetically with no rankings. Below: surgical billing traps and what to ask vendors.
Orthopedic billing is high-stakes billing. Individual surgical claims run into five figures, which means one coding error or one missed authorization costs more here than a month of mistakes in a lower-dollar specialty.
The complexity stacks up fast: 90-day global surgical periods, workers comp and auto claims alongside commercial payers, prior authorizations for MRIs and surgeries, and implant billing that payers love to deny. A vendor needs to handle all four at once.
Eight firms in our directory state orthopedics billing focus on their own websites, listed below in alphabetical order. Nothing is ranked, reviewed, or paid for. After the listings we cover the ortho-specific traps and the questions worth asking any vendor.
Medical billing companies for orthopedics
Matched by specialty focus stated on each firm's own site. Listed alphabetically; featured slots are paid and labeled.
8 firms listed
Revenue cycle outsourcing for billing companies, hospitals, software firms, and select practices.
Scottsdale, AZ
Dermatology · Orthopedics · Cardiology
Multi-specialty medical billing with denial management and accounts receivable recovery, serving cardiology, nephrology, and orthopedics.
New Jersey
Orthopedics · Cardiology
Medical billing across 10 specialties, including internal medicine, pediatrics, orthopedics, and chiropractic.
Albany, NY
Orthopedics · Pediatrics
Home health billing and credentialing; also serves internal medicine, cardiology, orthopedics, mental health, pediatrics, physical therapy, chiropractic, and surgical practices.
St. Petersburg, FL
Orthopedics · Cardiology · Pediatrics
Revenue cycle management for ambulatory surgery centers, office-based labs, and specialty practices.
Upland, CA
Orthopedics · Cardiology · Radiology
Billing for podiatry, dermatology, allergy and immunology, cardiology, pain management, psychology, orthopedic surgery, and physical therapy practices.
Voorhees Township, NJ
Dermatology · Orthopedics · Cardiology
End-to-end billing, coding, eligibility, denials, accounts receivable, and credentialing across 15+ specialties.
Brentwood, TN
Orthopedics · Cardiology · Pediatrics
Multi-specialty revenue cycle management.
Davis, CA
Orthopedics · Cardiology · Pediatrics
8
firms in our directory stating orthopedics billing focus
Source: BillingFirms directory data (verified 2026-10-01)
11.8%
average first-pass claim denial rate
Source: Kodiak Solutions
4-10%
percentage-of-collections range most billing vendors advertise
Source: billing vendor pricing guides
The global period problem
Most orthopedic surgeries carry a 90-day global period, meaning follow-up visits related to the surgery are bundled into the surgical payment. Billers who do not understand global periods either leave legitimate separately-billable visits on the table or bill included visits and trigger audits.
Modifier 24 for unrelated E/M during the global period and modifier 58 for staged procedures are where the money is won or lost. Your vendor should be able to explain both without hesitation and show you how they track global periods per patient.
Workers comp and auto claims
Orthopedic practices routinely juggle commercial payers, workers comp, and auto or PIP claims at the same time. Workers comp has its own fee schedules, its own authorization rules, and its own glacial payment timelines. Auto claims add liability carriers and letters of protection.
A generalist medical biller often handles the commercial claims fine and lets the comp and auto claims age into write-offs. Ask vendors what share of their current ortho work is workers comp and how they work those aging buckets.
Prior authorizations and implants
MRIs, injections, and surgeries all need prior authorization, and the criteria differ by payer and by procedure. Implant and hardware billing adds another layer: high-dollar line items that payers scrutinize and frequently downcode.
Confirm the vendor handles PA end to end, including peer-to-peer scheduling, and ask how they document medical necessity for implants. This is unglamorous work that directly protects your highest-value claims.
What to ask an orthopedic billing vendor
Use these questions on every sales call. Ortho billing has too many moving parts for a vendor to fake.
- How do you track 90-day global periods and bill modifier 24 visits?
- What share of your ortho work is workers comp, and how do you work those claims?
- Do you handle prior authorizations end to end, including peer-to-peers?
- How do you bill implants and hardware, and what is your denial rate on them?
- Can I speak with two current orthopedic clients?
Frequently asked questions
How much does orthopedic billing cost?
Orthopedic billing vendors commonly advertise 4 to 10 percent of collections, with surgical-heavy practices sometimes negotiating toward the lower end at high volume. Because individual claims are large, even small percentage differences matter. Clarify whether workers comp and auto claims are included in the percentage or priced separately.
What is a global surgical period?
A global surgical period is a window after surgery, usually 90 days for major orthopedic procedures, during which related follow-up care is bundled into the surgical payment. Visits during this window cannot be billed separately unless they are unrelated or staged. Billing errors here go both directions: missed legitimate charges or audit-triggering overbilling.
Why is workers comp billing harder than regular billing?
Workers comp uses separate fee schedules, separate authorization rules, and slower payment timelines than commercial insurance. Claims need injury details and employer information that commercial claims never ask for. Many generalist billers deprioritize comp claims, which is why ortho practices need a vendor that works them deliberately.
Do billing companies handle prior authorizations for surgery?
The good ones do, end to end: submitting the request, tracking it, handling peer-to-peer reviews, and documenting medical necessity. Confirm this is included in your agreement rather than assumed. A vendor that leaves PAs to your front desk is not really doing orthopedic billing.
How are implants and surgical hardware billed?
Implants are typically billed as supply line items alongside the surgical procedure codes, and payers frequently scrutinize or downcode them. Proper documentation of medical necessity and correct coding of the hardware are essential. Ask vendors about their denial and overturn rates specifically on implant line items.
How this list was made
Firms on this page are matched from the BillingFirms directory's verified data. A firm appears when orthopedics billing focus is stated on the firm's own public website, matched by our specialty taxonomy or specialty keywords. Listings are alphabetical. Nothing is ranked, reviewed, or vetted, and no firm currently holds a Featured placement.
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