Orthopedic surgery · Colorado

Orthopedic surgery commercial reimbursement in Colorado

How Colorado orthopedic surgery rates compare with the national market.

Orthopedic surgery in Colorado

39 codes · 107 sampled providers
Index vs national
107
7% above
Rank among states
20 of 51
1 = highest
Codes above national
32 of 39
median code at 107%
Providers
107
sampled

What the data shows

1

Orthopedic surgery ranks 20th of 51 states in Colorado with an index of 107 (100 = the specialty's national median), across 39 codes and 107 sampled providers.

2

Of the 39 orthopedic surgery codes with enough data in Colorado, 32 pay above the national median and 7 below; the typical code sits at 107% of the national median.

3

Largest premium over the national median: CPT 73502 (X-ray exam hip uni 2-3 views) at 123%; largest discount: CPT 26055 (Incise finger tendon sheath) at 93%.

4

Measured against Medicare, Colorado orthopedic surgery rates have a median of 157% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeColoradoNationalGapProv.
73502
X-ray exam hip uni 2-3 views
$74$60+23%106
73564
X-ray exam knee 4 or more
$73$60+22%106
73610
X-ray exam of ankle
$57$47+22%106
73562
X-ray exam of knee 3
$64$53+22%105
72148
Mri lumbar spine w/o dye
$449$370+21%95

Lowest vs national

CodeColoradoNationalGapProv.
26055
Incise finger tendon sheath
$572$614-7%103
27447
Total knee arthroplasty
$2,101$2,190-4%106
27130
Total hip arthroplasty
$2,104$2,158-2%106
20550
Njx 1 tendon sheath/ligament
$73$74-1%107
20611
Drain/inj joint/bursa w/us
$115$117-1%106

All orthopedic surgery codes in Colorado

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeColoradoNationalGap% of MedicareProvidersTINsLevel
CPT 73502
X-ray exam hip uni 2-3 views
$74$60+23%152%106182
CPT 73564
X-ray exam knee 4 or more
$73$60+22%147%106181
CPT 73610
X-ray exam of ankle
$57$47+22%154%106182
CPT 73562
X-ray exam of knee 3
$64$53+22%152%105176
CPT 72148
Mri lumbar spine w/o dye
$449$370+21%234%95144
CPT 73560
X-ray exam of knee 1 or 2
$54$45+21%157%106181
CPT 73030
X-ray exam of shoulder
$54$45+19%150%104181
CPT 73630
X-ray exam of foot
$53$44+19%155%106182
CPT 97110
Therapeutic exercises
$37$31+19%128%107183
CPT 99215
Office o/p est hi 40 min
$219$185+18%114%107184
CPT 73721
Mri jnt of lwr extre w/o dye
$457$387+18%224%95144
CPT 73221
Mri joint upr extrem w/o dye
$457$387+18%223%95144
CPT 72100
X-ray exam l-s spine 2/3 vws
$62$53+16%153%106179
CPT 99214
Office o/p est mod 30 min
$151$132+15%112%107186
CPT 72110
X-ray exam l-2 spine 4/>vws
$80$71+14%150%106180
CPT 99213
Office o/p est low 20 min
$102$91+13%108%107186
CPT 99205
Office o/p new hi 60 min
$284$252+13%120%107184
CPT 99204
Office o/p new mod 45 min
$213$194+10%120%107186
CPT 99203
Office o/p new low 30 min
$132$123+7%112%107186
CPT 99212
Office o/p est sf 10 min
$55$51+7%92%107185
CPT 29848
Wrist endoscopy/surgery
$847$817+4%174%105179
CPT 64721
Carpal tunnel surgery
$722$700+3%150%106182
CPT 29827
Sho arthrs srg rt8tr cuf rpr
$1,745$1,701+3%179%106181
CPT 27236
Treat thigh fracture
$1,957$1,918+2%180%103177
CPT 23472
Reconstruct shoulder joint
$2,346$2,318+1%180%106182
CPT 27487
Revise/replace knee joint
$2,866$2,840+1%182%103178
CPT 27245
Treat thigh fracture
$2,012$1,994+1%180%106181
CPT 93000
Electrocardiogram complete
$26$25+1%166%107181
CPT 22558
Arthrd ant ntrbd min dsc lum
$2,482$2,471+0%174%104177
CPT 22633
Arthrd cmbn 1ntrspc lumbar
$2,996$2,991+0%176%104177
CPT 63047
Lam facetec & foramot lumbar
$1,797$1,796+0%169%104179
CPT 22612
Arthrd pst tq 1ntrspc lumbar
$2,558$2,557+0%174%104179
CPT 20610
Drain/inj joint/bursa w/o us
$85$85-0%124%107185
CPT 22551
Arthrd ant ntrbdy cervical
$2,752$2,778-1%172%104180
CPT 20611
Drain/inj joint/bursa w/us
$115$117-1%230%106183
CPT 20550
Njx 1 tendon sheath/ligament
$73$74-1%121%107185
CPT 27130
Total hip arthroplasty
$2,104$2,158-3%181%106182
CPT 27447
Total knee arthroplasty
$2,101$2,190-4%181%106182
CPT 26055
Incise finger tendon sheath
$572$614-7%199%103181

Frequently asked questions

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

Colorado ranks 20th of 51 states with an index of 107; 32 of 39 codes are above the national median.

Which orthopedic surgery code has the biggest premium in Colorado?

CPT 73502 (X-ray exam hip uni 2-3 views), at 123% 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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