Orthopedic surgery · Maryland

Orthopedic surgery commercial reimbursement in Maryland

How Maryland orthopedic surgery rates compare with the national market.

Orthopedic surgery in Maryland

39 codes · 106 sampled providers
Index vs national
99
1% below
Rank among states
26 of 51
1 = highest
Codes above national
17 of 39
median code at 99%
Providers
106
sampled

What the data shows

1

Orthopedic surgery ranks 26th of 51 states in Maryland with an index of 99 (100 = the specialty's national median), across 39 codes and 106 sampled providers.

2

Of the 39 orthopedic surgery codes with enough data in Maryland, 17 pay above the national median and 22 below; the typical code sits at 99% of the national median.

3

Largest premium over the national median: CPT 97110 (Therapeutic exercises) at 110%; largest discount: CPT 73721 (Mri jnt of lwr extre w/o dye) at 86%.

4

Measured against Medicare, Maryland orthopedic surgery rates have a median of 149% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMarylandNationalGapProv.
97110
Therapeutic exercises
$35$31+10%105
29848
Wrist endoscopy/surgery
$856$817+5%105
99203
Office o/p new low 30 min
$128$123+4%106
99212
Office o/p est sf 10 min
$53$51+4%106
99215
Office o/p est hi 40 min
$191$185+3%105

Lowest vs national

CodeMarylandNationalGapProv.
73721
Mri jnt of lwr extre w/o dye
$331$387-14%101
73221
Mri joint upr extrem w/o dye
$332$387-14%101
72148
Mri lumbar spine w/o dye
$327$370-12%101
26055
Incise finger tendon sheath
$549$614-11%105
20611
Drain/inj joint/bursa w/us
$105$117-10%105

All orthopedic surgery codes in Maryland

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMarylandNationalGap% of MedicareProvidersTINsLevel
CPT 97110
Therapeutic exercises
$35$31+10%119%105189
CPT 29848
Wrist endoscopy/surgery
$856$817+5%176%105190
CPT 99203
Office o/p new low 30 min
$128$123+4%109%106192
CPT 99212
Office o/p est sf 10 min
$53$51+4%90%106192
CPT 99215
Office o/p est hi 40 min
$191$185+3%99%105191
CPT 99214
Office o/p est mod 30 min
$136$132+3%100%106192
CPT 22612
Arthrd pst tq 1ntrspc lumbar
$2,623$2,557+3%179%105193
CPT 64721
Carpal tunnel surgery
$718$700+3%149%106193
CPT 29827
Sho arthrs srg rt8tr cuf rpr
$1,736$1,701+2%178%106193
CPT 27236
Treat thigh fracture
$1,957$1,918+2%180%105191
CPT 63047
Lam facetec & foramot lumbar
$1,827$1,796+2%171%105194
CPT 99204
Office o/p new mod 45 min
$197$194+2%111%106193
CPT 27245
Treat thigh fracture
$2,024$1,994+1%181%105191
CPT 99205
Office o/p new hi 60 min
$256$252+1%108%106193
CPT 27487
Revise/replace knee joint
$2,875$2,840+1%183%105191
CPT 27447
Total knee arthroplasty
$2,210$2,190+1%191%106193
CPT 22633
Arthrd cmbn 1ntrspc lumbar
$2,996$2,991+0%176%105192
CPT 22558
Arthrd ant ntrbd min dsc lum
$2,470$2,471-0%174%105192
CPT 22551
Arthrd ant ntrbdy cervical
$2,772$2,778-0%173%105193
CPT 73560
X-ray exam of knee 1 or 2
$44$45-1%129%104190
CPT 99213
Office o/p est low 20 min
$90$91-1%94%106194
CPT 73502
X-ray exam hip uni 2-3 views
$59$60-2%121%105193
CPT 27130
Total hip arthroplasty
$2,113$2,158-2%182%105192
CPT 73610
X-ray exam of ankle
$46$47-2%124%105193
CPT 23472
Reconstruct shoulder joint
$2,258$2,318-3%174%105193
CPT 73630
X-ray exam of foot
$43$44-3%127%105191
CPT 73562
X-ray exam of knee 3
$51$53-3%121%105192
CPT 93000
Electrocardiogram complete
$25$25-3%160%104192
CPT 73564
X-ray exam knee 4 or more
$58$60-3%117%104191
CPT 73030
X-ray exam of shoulder
$43$45-4%121%105193
CPT 72100
X-ray exam l-s spine 2/3 vws
$51$53-4%126%105190
CPT 72110
X-ray exam l-2 spine 4/>vws
$68$71-4%127%104190
CPT 20610
Drain/inj joint/bursa w/o us
$81$85-5%118%106194
CPT 20550
Njx 1 tendon sheath/ligament
$69$74-7%114%106194
CPT 20611
Drain/inj joint/bursa w/us
$105$117-10%211%105192
CPT 26055
Incise finger tendon sheath
$549$614-11%191%105189
CPT 72148
Mri lumbar spine w/o dye
$327$370-12%171%101186
CPT 73221
Mri joint upr extrem w/o dye
$332$387-14%162%101185
CPT 73721
Mri jnt of lwr extre w/o dye
$331$387-14%162%101186

Frequently asked questions

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

Maryland ranks 26th of 51 states with an index of 99; 17 of 39 codes are above the national median.

Which orthopedic surgery code has the biggest premium in Maryland?

CPT 97110 (Therapeutic exercises), at 110% 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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