Orthopedic surgery · Florida

Orthopedic surgery commercial reimbursement in Florida

How Florida orthopedic surgery rates compare with the national market.

Orthopedic surgery in Florida

39 codes · 108 sampled providers
Index vs national
78
22% below
Rank among states
49 of 51
1 = highest
Codes above national
0 of 39
median code at 78%
Providers
108
sampled

What the data shows

1

Orthopedic surgery ranks 49th of 51 states in Florida with an index of 78 (100 = the specialty's national median), across 39 codes and 108 sampled providers.

2

Of the 39 orthopedic surgery codes with enough data in Florida, 0 pay above the national median and 39 below; the typical code sits at 78% of the national median.

3

Largest premium over the national median: CPT 99203 (Office o/p new low 30 min) at 88%; largest discount: CPT 72100 (X-ray exam l-s spine 2/3 vws) at 59%.

4

Measured against Medicare, Florida orthopedic surgery rates have a median of 108% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeFloridaNationalGapProv.
99203
Office o/p new low 30 min
$109$123-12%108
99204
Office o/p new mod 45 min
$168$194-13%108
99205
Office o/p new hi 60 min
$218$252-13%108
99214
Office o/p est mod 30 min
$111$132-15%108
99212
Office o/p est sf 10 min
$43$51-16%108

Lowest vs national

CodeFloridaNationalGapProv.
72100
X-ray exam l-s spine 2/3 vws
$32$53-41%108
72110
X-ray exam l-2 spine 4/>vws
$42$71-41%108
73564
X-ray exam knee 4 or more
$36$60-40%108
73030
X-ray exam of shoulder
$27$45-39%108
73630
X-ray exam of foot
$27$44-39%108

All orthopedic surgery codes in Florida

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeFloridaNationalGap% of MedicareProvidersTINsLevel
CPT 99203
Office o/p new low 30 min
$109$123-12%92%108133
CPT 99204
Office o/p new mod 45 min
$168$194-13%95%108133
CPT 99205
Office o/p new hi 60 min
$218$252-13%92%108133
CPT 99214
Office o/p est mod 30 min
$111$132-15%82%108133
CPT 99212
Office o/p est sf 10 min
$43$51-16%73%108133
CPT 99215
Office o/p est hi 40 min
$155$185-16%81%108133
CPT 99213
Office o/p est low 20 min
$75$91-17%79%108133
CPT 22551
Arthrd ant ntrbdy cervical
$2,265$2,778-18%141%108132
CPT 22633
Arthrd cmbn 1ntrspc lumbar
$2,411$2,991-19%142%108130
CPT 22558
Arthrd ant ntrbd min dsc lum
$1,981$2,471-20%139%108129
CPT 22612
Arthrd pst tq 1ntrspc lumbar
$2,036$2,557-20%139%108130
CPT 23472
Reconstruct shoulder joint
$1,836$2,318-21%141%108130
CPT 27245
Treat thigh fracture
$1,572$1,994-21%141%108132
CPT 26055
Incise finger tendon sheath
$483$614-21%168%108132
CPT 63047
Lam facetec & foramot lumbar
$1,411$1,796-21%132%108132
CPT 20611
Drain/inj joint/bursa w/us
$92$117-22%183%108132
CPT 27447
Total knee arthroplasty
$1,715$2,190-22%148%108132
CPT 29827
Sho arthrs srg rt8tr cuf rpr
$1,329$1,701-22%136%108132
CPT 29848
Wrist endoscopy/surgery
$636$817-22%131%108131
CPT 27487
Revise/replace knee joint
$2,203$2,840-22%140%108130
CPT 27236
Treat thigh fracture
$1,487$1,918-22%136%108132
CPT 20550
Njx 1 tendon sheath/ligament
$57$74-23%94%108133
CPT 20610
Drain/inj joint/bursa w/o us
$65$85-24%95%108133
CPT 27130
Total hip arthroplasty
$1,649$2,158-24%142%108131
CPT 93000
Electrocardiogram complete
$19$25-24%126%108126
CPT 64721
Carpal tunnel surgery
$524$700-25%108%108132
CPT 97110
Therapeutic exercises
$22$31-28%77%108132
CPT 73221
Mri joint upr extrem w/o dye
$268$387-31%131%107118
CPT 73721
Mri jnt of lwr extre w/o dye
$266$387-31%130%107118
CPT 72148
Mri lumbar spine w/o dye
$254$370-31%132%107118
CPT 73560
X-ray exam of knee 1 or 2
$28$45-38%81%108128
CPT 73502
X-ray exam hip uni 2-3 views
$37$60-38%77%108129
CPT 73610
X-ray exam of ankle
$29$47-38%78%108129
CPT 73562
X-ray exam of knee 3
$32$53-39%76%108129
CPT 73630
X-ray exam of foot
$27$44-39%80%108129
CPT 73030
X-ray exam of shoulder
$27$45-39%77%108130
CPT 73564
X-ray exam knee 4 or more
$36$60-40%73%108130
CPT 72110
X-ray exam l-2 spine 4/>vws
$42$71-41%78%108129
CPT 72100
X-ray exam l-s spine 2/3 vws
$32$53-41%78%108128

Frequently asked questions

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

Florida ranks 49th of 51 states with an index of 78; 0 of 39 codes are above the national median.

Which orthopedic surgery code has the biggest premium in Florida?

CPT 99203 (Office o/p new low 30 min), at 88% 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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