Orthopedic Billing Services That Deliver Financial Precision

Smarter Ortho RCM That Delivers Results

Running an orthopedic group isn’t just about delivering excellent clinical care it’s about protecting the revenue tied to it. From surgical billing to joint injections and implant reimbursement, margin erosion happens fast without the right strategy. At Scionis RCM, we don’t use templates we build systems designed around your practice’s real workflow. We get inside your revenue cycle, fix what’s leaking, and build financial discipline across your coding and billing pipeline.

Common Orthopedic Billing Mistakes That Erode Revenue

Even high-functioning orthopedic clinics routinely lose money due to preventable billing errors:

Surgeries postponed due to slow or denied prior authorizations
Claims denied when assistant surgeon modifiers (62, 80, 81) are misapplied
Left/right inaccuracies causing full denials or halved reimbursements
Injections miscoded or missing drug linkage, reducing payments
Implant charges dropped due to misaligned OR logs and documentation
Aging A/R neglected because of fragmented follow-up processes

We catch these before they cost you.

Orthopedic Revenue Cycle Fixes Built by Experts, Not Guesswork

At Scionis RCM, we specialize in orthopedic revenue operations for clinics, ASCs, and MSOs. Our systems aren’t generic they’re built for the high-risk, high-dollar nature of orthopedic billing.

Fracture, Injection & Joint Coding Accuracy
We apply exact CPTs like 20610, 20611, 27447, and 27130 with matching ICD-10s. No more guessing between bundled vs. unbundled claims.
Implant Billing Done Right
Our team reconciles every OR log, charge sheet, and supply use making sure screws, anchors, cages, and biologics are never left off a claim.
Faster, Compliant Prior Authorizations
Most auths approved within 48 hours keeping your OR bookings intact and reducing last-minute rescheduling.
Modifier Precision and Policy Alignment
Whether it’s 50, RT/LT, or co-surgeon logic, our billing aligns with both the operative note and the payer’s policy maximizing reimbursement.
A/R Managed in Real Time
Denials are tracked, corrected, and appealed with urgency. Each claim tagged by root cause modifier errors, coding gaps, documentation mismatches.
Clear Reporting That Guides Decisions
We deliver weekly dashboards showing where delays happen auths, coding, billing submission, or payer pushback.

Why Orthopedic Revenue Needs Specialists

General billing teams miss details that cost your practice big:

Modifiers applied inconsistently, especially on bilateral or staged procedures
Fracture care coded incorrectly due to unfamiliarity with global periods
Injection services underbilled no 59 modifier or missing J-code linkage
Assistant surgeon denials never appealed or not billed at all
Orthopedic billing is surgical. So is our approach.

What You Can Expect With Scionis RCM

36% reduction in implant-related denials within 90 days
Over $470K annually recovered from missed CPT capture
Prior auth approvals improved from 5+ days to under 48 hours
Clean claim rate of 94%+ across Medicare, BCBS, UHC, and Aetna

Orthopedic Billing FAQs

How do you reduce assistant surgeon denials?
We use modifiers 80/81/82 only when supported by op note documentation and match them to payer-specific guidelines to avoid auto-denials.
Do you bill bilateral procedures differently?
Yes modifier 50, RT, or LT is applied with supporting documentation, ensuring payment for both sides as per policy.
Are joint injections often miscoded?
Yes. Practices often confuse CPT 20610 with 20611 or skip drug linkage. We capture it all by cross-verifying with EMR and supply logs.
Which CPTs bring the most revenue to orthopedic practices?
Codes like 27447, 27130, 23472, and 22551 drive high revenue but are often flagged by payers. We proactively monitor these for edits and denial risks.
How do you ensure all implants are reimbursed?
We match OR logs, op reports, and charge masters. If it’s used clinically, it’s tracked and billed. Missed charges are identified before submission.

Need Help Plugging the Leaks?

Request your free audit. We’ll flag overlooked revenue, denials you can recover, and show you how fast we can turn your numbers around.

Scionis RCM | Built for Orthopedics. Focused on Results.

Want to work with us?

Partner with Us to Drive Excellence

Unlock your healthcare organization’s true financial potential with Scionis RCMs. We specialize in streamlining complex revenue processes, recovering lost revenue, and optimizing cash flow. With our expertise, you can focus on delivering exceptional patient care while we enhance your financial efficiency and growth.