Orthopedic surgery · Georgia

Orthopedic surgery commercial reimbursement in Georgia

How Georgia orthopedic surgery rates compare with the national market.

Orthopedic surgery in Georgia

39 codes · 124 sampled providers
Index vs national
113
13% above
Rank among states
15 of 51
1 = highest
Codes above national
39 of 39
median code at 113%
Providers
124
sampled

What the data shows

1

Orthopedic surgery ranks 15th of 51 states in Georgia with an index of 113 (100 = the specialty's national median), across 39 codes and 124 sampled providers.

2

Of the 39 orthopedic surgery codes with enough data in Georgia, 39 pay above the national median and 0 below; the typical code sits at 113% of the national median.

3

Largest premium over the national median: CPT 73221 (Mri joint upr extrem w/o dye) at 129%; largest discount: CPT 99215 (Office o/p est hi 40 min) at 104%.

4

Measured against Medicare, Georgia orthopedic surgery rates have a median of 159% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeGeorgiaNationalGapProv.
73221
Mri joint upr extrem w/o dye
$497$387+28%124
73721
Mri jnt of lwr extre w/o dye
$495$387+28%124
72148
Mri lumbar spine w/o dye
$470$370+27%124
93000
Electrocardiogram complete
$30$25+20%124
20610
Drain/inj joint/bursa w/o us
$102$85+19%124

Lowest vs national

CodeGeorgiaNationalGapProv.
99215
Office o/p est hi 40 min
$193$185+4%124
99213
Office o/p est low 20 min
$95$91+5%124
73502
X-ray exam hip uni 2-3 views
$64$60+6%124
99214
Office o/p est mod 30 min
$141$132+7%124
99205
Office o/p new hi 60 min
$274$252+9%124

All orthopedic surgery codes in Georgia

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeGeorgiaNationalGap% of MedicareProvidersTINsLevel
CPT 73221
Mri joint upr extrem w/o dye
$497$387+29%242%124229
CPT 73721
Mri jnt of lwr extre w/o dye
$495$387+28%242%124229
CPT 72148
Mri lumbar spine w/o dye
$470$370+27%245%124229
CPT 93000
Electrocardiogram complete
$30$25+20%198%124230
CPT 20610
Drain/inj joint/bursa w/o us
$102$85+19%148%124235
CPT 20611
Drain/inj joint/bursa w/us
$138$117+18%275%124231
CPT 97110
Therapeutic exercises
$37$31+17%127%124235
CPT 20550
Njx 1 tendon sheath/ligament
$86$74+17%142%124236
CPT 27447
Total knee arthroplasty
$2,545$2,190+16%220%124236
CPT 73630
X-ray exam of foot
$51$44+15%151%124232
CPT 29827
Sho arthrs srg rt8tr cuf rpr
$1,961$1,701+15%201%124234
CPT 73610
X-ray exam of ankle
$54$47+15%146%124232
CPT 23472
Reconstruct shoulder joint
$2,652$2,318+14%204%124235
CPT 27236
Treat thigh fracture
$2,187$1,918+14%201%124234
CPT 26055
Incise finger tendon sheath
$699$614+14%243%124235
CPT 73560
X-ray exam of knee 1 or 2
$51$45+14%147%124232
CPT 22612
Arthrd pst tq 1ntrspc lumbar
$2,900$2,557+13%198%124233
CPT 72110
X-ray exam l-2 spine 4/>vws
$80$71+13%150%124231
CPT 22558
Arthrd ant ntrbd min dsc lum
$2,795$2,471+13%196%124234
CPT 27487
Revise/replace knee joint
$3,210$2,840+13%204%124235
CPT 22633
Arthrd cmbn 1ntrspc lumbar
$3,379$2,991+13%199%124230
CPT 73562
X-ray exam of knee 3
$60$53+13%141%124230
CPT 27245
Treat thigh fracture
$2,243$1,994+13%201%124235
CPT 72100
X-ray exam l-s spine 2/3 vws
$60$53+12%147%123227
CPT 73564
X-ray exam knee 4 or more
$67$60+12%136%124233
CPT 99203
Office o/p new low 30 min
$138$123+12%117%124236
CPT 22551
Arthrd ant ntrbdy cervical
$3,107$2,778+12%194%124230
CPT 29848
Wrist endoscopy/surgery
$913$817+12%188%124232
CPT 27130
Total hip arthroplasty
$2,409$2,158+12%207%124234
CPT 73030
X-ray exam of shoulder
$50$45+11%140%124233
CPT 63047
Lam facetec & foramot lumbar
$1,998$1,796+11%188%124233
CPT 99204
Office o/p new mod 45 min
$214$194+11%121%124236
CPT 99212
Office o/p est sf 10 min
$57$51+10%95%124237
CPT 64721
Carpal tunnel surgery
$769$700+10%159%124236
CPT 99205
Office o/p new hi 60 min
$274$252+9%116%124236
CPT 99214
Office o/p est mod 30 min
$141$132+7%104%124237
CPT 73502
X-ray exam hip uni 2-3 views
$64$60+6%131%124228
CPT 99213
Office o/p est low 20 min
$95$91+5%100%124237
CPT 99215
Office o/p est hi 40 min
$193$185+4%100%124237

Frequently asked questions

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

Georgia ranks 15th of 51 states with an index of 113; 39 of 39 codes are above the national median.

Which orthopedic surgery code has the biggest premium in Georgia?

CPT 73221 (Mri joint upr extrem w/o dye), at 129% 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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