Orthopedic surgery · Arizona

Orthopedic surgery commercial reimbursement in Arizona

How Arizona orthopedic surgery rates compare with the national market.

Orthopedic surgery in Arizona

39 codes · 99 sampled providers
Index vs national
87
13% below
Rank among states
42 of 51
1 = highest
Codes above national
0 of 39
median code at 87%
Providers
99
sampled

What the data shows

1

Orthopedic surgery ranks 42nd of 51 states in Arizona with an index of 87 (100 = the specialty's national median), across 39 codes and 99 sampled providers.

2

Of the 39 orthopedic surgery codes with enough data in Arizona, 0 pay above the national median and 39 below; the typical code sits at 87% of the national median.

3

Largest premium over the national median: CPT 97110 (Therapeutic exercises) at 97%; largest discount: CPT 72148 (Mri lumbar spine w/o dye) at 78%.

4

Measured against Medicare, Arizona orthopedic surgery rates have a median of 124% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeArizonaNationalGapProv.
97110
Therapeutic exercises
$30$31-3%98
99205
Office o/p new hi 60 min
$232$252-8%99
26055
Incise finger tendon sheath
$563$614-8%99
93000
Electrocardiogram complete
$23$25-8%99
22633
Arthrd cmbn 1ntrspc lumbar
$2,728$2,991-9%99

Lowest vs national

CodeArizonaNationalGapProv.
72148
Mri lumbar spine w/o dye
$290$370-22%98
99212
Office o/p est sf 10 min
$41$51-20%99
99213
Office o/p est low 20 min
$74$91-18%99
73630
X-ray exam of foot
$37$44-17%99
72100
X-ray exam l-s spine 2/3 vws
$44$53-17%99

All orthopedic surgery codes in Arizona

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeArizonaNationalGap% of MedicareProvidersTINsLevel
CPT 97110
Therapeutic exercises
$30$31-3%104%98139
CPT 99205
Office o/p new hi 60 min
$232$252-8%98%99142
CPT 26055
Incise finger tendon sheath
$563$614-8%196%99140
CPT 93000
Electrocardiogram complete
$23$25-8%151%99141
CPT 22633
Arthrd cmbn 1ntrspc lumbar
$2,728$2,991-9%160%99136
CPT 22551
Arthrd ant ntrbdy cervical
$2,527$2,778-9%157%99137
CPT 22558
Arthrd ant ntrbd min dsc lum
$2,247$2,471-9%158%99135
CPT 22612
Arthrd pst tq 1ntrspc lumbar
$2,324$2,557-9%158%99137
CPT 99204
Office o/p new mod 45 min
$175$194-10%99%99145
CPT 73502
X-ray exam hip uni 2-3 views
$54$60-10%111%99141
CPT 27245
Treat thigh fracture
$1,759$1,994-12%157%99141
CPT 27130
Total hip arthroplasty
$1,904$2,158-12%164%99140
CPT 23472
Reconstruct shoulder joint
$2,044$2,318-12%157%99137
CPT 99203
Office o/p new low 30 min
$107$123-13%91%99145
CPT 27487
Revise/replace knee joint
$2,470$2,840-13%157%99138
CPT 27236
Treat thigh fracture
$1,667$1,918-13%153%99139
CPT 63047
Lam facetec & foramot lumbar
$1,561$1,796-13%146%99139
CPT 27447
Total knee arthroplasty
$1,903$2,190-13%164%99142
CPT 29827
Sho arthrs srg rt8tr cuf rpr
$1,478$1,701-13%151%99138
CPT 29848
Wrist endoscopy/surgery
$709$817-13%146%99138
CPT 20610
Drain/inj joint/bursa w/o us
$74$85-13%108%99145
CPT 20611
Drain/inj joint/bursa w/us
$100$117-14%200%99141
CPT 73564
X-ray exam knee 4 or more
$51$60-14%104%99141
CPT 64721
Carpal tunnel surgery
$601$700-14%124%99142
CPT 99215
Office o/p est hi 40 min
$158$185-14%82%99142
CPT 99214
Office o/p est mod 30 min
$112$132-15%83%99147
CPT 73560
X-ray exam of knee 1 or 2
$38$45-15%111%99142
CPT 20550
Njx 1 tendon sheath/ligament
$63$74-15%104%99141
CPT 73221
Mri joint upr extrem w/o dye
$328$387-15%160%98135
CPT 73030
X-ray exam of shoulder
$38$45-15%107%99143
CPT 73721
Mri jnt of lwr extre w/o dye
$327$387-15%160%98134
CPT 73562
X-ray exam of knee 3
$45$53-16%105%99142
CPT 73610
X-ray exam of ankle
$39$47-16%106%99142
CPT 72110
X-ray exam l-2 spine 4/>vws
$59$71-16%111%99138
CPT 72100
X-ray exam l-s spine 2/3 vws
$44$53-17%109%99140
CPT 73630
X-ray exam of foot
$37$44-17%108%99143
CPT 99213
Office o/p est low 20 min
$74$91-18%78%99149
CPT 99212
Office o/p est sf 10 min
$41$51-20%69%99142
CPT 72148
Mri lumbar spine w/o dye
$290$370-22%151%98134

Frequently asked questions

How do Arizona orthopedic surgery rates compare with the rest of the country?

Arizona ranks 42nd of 51 states with an index of 87; 0 of 39 codes are above the national median.

Which orthopedic surgery code has the biggest premium in Arizona?

CPT 97110 (Therapeutic exercises), at 97% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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