Orthopedics
Revenue intelligence for Orthopedic practices. E&M coding benchmarks, surgical documentation, and emerging care management opportunities.
$68K
Avg Missed/Year
24K
US Providers
480
Avg Patients
2.2
Avg Chronic Dx
Specialty Overview
Orthopedic practices have traditionally focused on surgical revenue, but E&M coding optimization represents the largest missed opportunity. With 480 average Medicare patients and the highest 99213 usage (35%) of any specialty, the undercoding gap is substantial. Care management programs are less applicable but still relevant for patients with comorbid chronic conditions.
Key Insight: Orthopedics leaves the most money in E&M coding — shifting just 5 visits per day from 99213 to 99214 adds $47,000+ annually with zero additional patient volume.
E&M Coding Distribution
National benchmark for Orthopedics E&M code distribution. Compare your practice against these targets to identify coding optimization opportunities.
99213
35%
$92/visit
99214
48%
$130/visit
99215
17%
$176/visit
Revenue Gap Breakdown
E&M Coding Gap
35% 99213 usage is the highest of any specialty. Post-operative visits and complex injury management support higher coding levels.
CCM (99490)
Only 5% adoption, but patients with arthritis plus another chronic condition qualify. The volume may be lower but per-patient value is the same.
RPM (99453-99458)
RTM (Remote Therapeutic Monitoring) for post-surgical recovery is an emerging opportunity. 4% current adoption.
AWV (G0438/G0439)
8% AWV rate reflects specialist focus, but patients should be referred for wellness visits.
BHI (99484)
Chronic pain and depression overlap frequently. Screening orthopedic patients for BHI eligibility is low-hanging fruit.
Care Management Adoption Rates
CCM
5%
Target: 15%
RPM
4%
Target: 10%
BHI
2%
Target: 10%
AWV
8%
Target: 70%
Common Chronic Conditions
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