Orthopedics

Specialty · Orthopedics

Orthopedic groups leave revenue on the table at code level.

Modifier-heavy procedures, ASC fee schedules, and high-dollar arthroscopy codes are exactly where payer drift compounds. Aroris benchmarks every code on every contract, surfaces the gap, and signs new rates.

Where orthopedic revenue drifts

The four code families we see leaking most.

Orthopedics combines high-dollar surgical codes, ASC facility fees, and heavy modifier use — three independent ways for payer drift to compound. These are the code families where we most often find groups underpaid against their own contracts.

29881

Knee arthroscopy w/ meniscectomy

High-dollar and high-frequency. Commercial underpayment here is rarely visible without ASC fee-schedule benchmarking, which most groups never run.

27447

Total knee arthroplasty

One of the largest single line items in any ortho contract. Even a low single-digit drift translates into a material annual figure.

27130

Total hip arthroplasty

The same exposure profile as TKA: high per-case value means small percentage gaps become large dollar gaps quickly.

20610

Major joint injection

High volume, low per-unit — the classic compounding-drift profile where no single claim ever trips an alarm.

99213 / 99214

Office E/M

Pre-op and post-op visit volume makes E/M drift add up faster in ortho than the per-claim gap suggests.

-50, -RT, -LT

Modifier handling

Bilateral and side-specific modifiers are frequently downcoded or not honored. Aroris tracks the pattern by payer and prices it into the rate case.

How Aroris works with orthopedic groups

Specialty-aligned negotiators, ortho-specific benchmarks.

1. Ortho-specific benchmark

Every code in your contract priced against the ortho-only subset of the Aroris dataset — not generic peer averages.

2. ASC + professional cases

We build rate cases for both the facility fee schedule and the professional component, code by code.

3. Live monitoring after

Once new rates are signed, every claim is reconciled daily — modifiers, bilaterals, and bundling failures all flagged.

Proof in ortho

What we’ve signed for orthopedic groups.

Orthopedic groups have the highest per-case value of any specialty Aroris works with, and the most modifier exposure. Here is the shape of a typical engagement.

Illustrative figures for layout review. Final signed-result numbers pending client approval.

+5–10%

Typical blended commercial lift across the arthroplasty and arthroscopy families after corrected rates are signed.

3–5 mo

Benchmark to signed rate amendment for a multi-site orthopedic group.

$400K–$1.1M

Illustrative annualized recovery range for a large orthopedic practice with an ASC. Modeled per contract in the free assessment.

For orthopedic groups

See what your contracts are owed.

The free Aroris assessment models your dollar range of opportunity at code-modifier-plan level — usually in 5 business days.