Orthopedic Medical Billing Services for Surgeons and ASCs

Recover lost revenue to laterality errors, global period mistakes, and billing and coding mistakes with our specialized billing services. We have AAPC-certified coders and an AI-driven billing platform that validates everything resulting in fewer denials and better reimbursement.

Orthopedic CPT Coding Compliance

Coding mistakes are very common and trigger automatic denials. A missed RT/LT modifier, an incorrect Modifiers 51 application, or a wrong open versus arthroscopic code are among the main reasons. We have orthopedic billing specialists who make sure no coding errors happen. With our orthopedic billing services, you can rest assured that your every claim follows current payer rules and NCCI edits.

Global Period Billing Management

Orthopedic surgeries include a 90-day global period. Routine post-op visits should be billed with the right modifier. Misapplying the -58, -78, or -79 modifier can result in immediate denial. Our orthopedic billing services track every surgery date during the global period, post-op visits are noted, and billable services are on record. This keeps you compliant and reimburses every dollar you owe.

Orthopedic Procedures We Cover

We handle billing for every orthopedic procedure, including joint replacements (CPT 27447, 27130), shoulder and knee arthroscopy (29881, 29827), spinal fusion(22612), and the rest. Whether you are operating in a clinic, ASC, or hospital setting, our coders understand every procedure-specific rule. Our certified coders understand documentation requirements and payer policies that affect reimbursement and always code accordingly.

Prior Authorization Management

Prior authorization is now required in 92% of orthopedic ASC claims. Under CMS-0057-F, payers responds in around seven days which makes incomplete first submission will leave a little room for correction if the first submission is incomplete. Our billing specialists create and manage an authorization workflow that submits complete clinical documentation and tracks every request so that no service goes unbilled.

We Are Certified by:

Denial Prevention and Appeals

Denied claims put your practice at a compliance and revenue risk which compounds with time. Our orthopedic medical billing services are built on validation powered by AI. We validate every claim to identify and remove any errors before submission. This assures that no denial happens and even if a denial occurs, we go straight to the root cause and file a structured appeal quickly to recover revenue.

Who We Serve

Hospital Orthopedic Departments

Ambulatory Surgery Centers (ASCs)

Orthopedic Surgeons (MD/DO)

Sports Medicine & Musculoskeletal Practices

Spine, Joint Replacement & Orthopedic Specialty Clinics

Why Choose MedCare MSO Orthopedic Billing Company?

What Our Clients Say About Working With Us

Frequently Asked Questions

We update protocols every time CMS releases new rules for CPT and ICD-10 updates. The 2026 CPT set has introduced 288 new codes with significant musculoskeletal changes which our coders implemented on the exact day they were released.

Yes, surely we can. We will integrate our billing platforms with your existing healthcare systems with our AI-powered solutions. This will provide pre-bill validation and our certified professionals will take care of the other orthopedic billing tasks and reduce your denial rates significantly.

Absolutely. We manage complete orthopedic encounters from E/M visits and injections to joint replacements, fracture care, arthroscopy, and spinal surgery. You will get a dedicated team that will take care of CPT coding, modifiers, implant billing, and post-op claims with precision.

There are multiple reasons why. First, you get AAPC-certified coders, payer-specific expertise, denial management workflows, and many other billing solutions. You won’t need an in-house team, instead you can count on our orthopedic medical billing specialists to process clean claims and better reimbursements.

We serve all types of practices, centers, ASCs, clinics, and hospitals, just name it. This means we can manage billing across multiple locations simultaneously by applying correct place-of-service codes, site-specific payer rules, and billing requirements.

Increase your Practice Revenue by up to 30% With Medcare MSO

Lets get connected

Please provide the following information, so our team can connect with you within 12 hours.
Or call us as 800-640-6409

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Dr. Jose Correa

TXEC

I have worked with MedCare MSO for the past eight months, and it has been a great experience. Moses, Mark, Travis, Sebastian, and Tammy have been a pleasure to work with, as well as the rest of the team, including the credentialing folks.

I highly recommend this group and MedCare MSO if you are looking for help with your billing. They will meet with you once a week to review the issues that need to be fixed to improve your payment and capture rate.

If you are looking for help with your billing and gain some freedom to see more patients or manage your business, this is the team you need to work with.

Dr. Jose Correa

Practice Owner

TXEC

Shaunna Mock

STST

MedCare MSO has been an excellent organization to work with. Mark has consistently demonstrated outstanding attention to detail, thorough documentation, and strong professionalism in maintaining accurate records of his findings.

His reliability and dedication have contributed greatly to a positive experience.

I highly recommend MedCare MSO for their quality of service and commitment to excellence. I can’t say enough good things about Mark and his company.

Thank you

Shaunna Mock

Back Office Manager

STST

Max Owens

SC & SF

Hi Ali, I hope this message finds you well. I wanted to give you some feedback on the team.

We are definitely impressed by the Team’s performance. Definitely what we were looking for from switching partners.

In particular Mark Zaiden has been very helpful. In my 5+ years of experience as a M&A Professional, I worked with a lot of different folks from all over the world on different business transactions, and Mark is truly a top notch talent!

Austin has done a great job of leading the communications process and keeping the train going in the right direction. Tammy and some other folks have been key players as well. We really are happy with everyone on the team.

I wanted to pass this feedback along to you as we are really pleased with working with MedCare MSO so far.

Have a great weekend!

Max Owens

Director of Corporate Development

SC & SF

Kelly Ballou

R.D.

MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!

Most helpful is the open/responsive communication of their team with my office and each other, along with the specialty levels of expertise amongst my team for each aspect of RCM.

Kelly Ballou

Owner

R.D.

Bret

PCP

MedCare MSO did a great job with our billing and helping clean up old AR. Regular updates and good communication were very appreciated. It was nice to not have to worry about billing and to focus on patient care. Thanks!

Bret

Co-Owner

PCP

Dr. Chess

F&A Clinic

Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.

 

I would like to take time to recognize two members of MedCare MSO specifically. Moses for his exceptional support and dedication. He is always responsive, and knowledgeable, and goes above and beyond to ensure smooth operations. His professionalism and commitment make a huge difference in our day-to-day workflow. George also for his quick feedback and recognition of what is needed most. He is extremely efficient and always available for clarification and to share his knowledge and expertise.

 

I highly recommend MedCare MSO to any healthcare provider looking for a reliable and efficient billing partner.

Daniel

RLT

Hello,

I am writing this email to express our appreciation of the MedCare MSO’s team and all they have done for our business at RLT. In the past year, we have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage. We went from having over $100k in uncollected/billed claims to now reaching near $100k in collection some months.

 

We are also happy to express our thankfulness that MedCare MSO is now helping us acquire new contracts with different insurance companies. This will in effect benefit everyone involved, allowing us to expand our services and provide more resources for our staff/business partners.

 

Please note special appreciation for the following:

David Lucas

Mario Ortega

Ambrose William

Dr. Neufeld

FBH

I have been a customer of MedCare MSO for one year. They have provided billing and credentialing services for my private behavioral health practice, and I am impressed with their promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases, and with their willingness to educate me and my staff about the ever-changing rules of medical billing and the best use of coding. This is a company I Trust with my billing needs.

Dr. Neufeld

Practice Owner

FBH

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Let’s Get in Touch

If you’d like to talk to someone now, give us a call at 800-640-6409. ​
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