Orthopedic surgery · Minnesota

Orthopedic surgery commercial reimbursement in Minnesota

How Minnesota orthopedic surgery rates compare with the national market.

Orthopedic surgery in Minnesota

39 codes · 102 sampled providers
Index vs national
120
20% above
Rank among states
13 of 51
1 = highest
Codes above national
30 of 39
median code at 120%
Providers
102
sampled

What the data shows

1

Orthopedic surgery ranks 13th of 51 states in Minnesota with an index of 120 (100 = the specialty's national median), across 39 codes and 102 sampled providers.

2

Of the 39 orthopedic surgery codes with enough data in Minnesota, 30 pay above the national median and 9 below; the typical code sits at 120% of the national median.

3

Largest premium over the national median: CPT 99212 (Office o/p est sf 10 min) at 159%; largest discount: CPT 93000 (Electrocardiogram complete) at 72%.

4

Measured against Medicare, Minnesota orthopedic surgery rates have a median of 165% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMinnesotaNationalGapProv.
99212
Office o/p est sf 10 min
$82$51+59%102
99214
Office o/p est mod 30 min
$204$132+55%102
99213
Office o/p est low 20 min
$139$91+53%102
99204
Office o/p new mod 45 min
$286$194+48%102
99203
Office o/p new low 30 min
$175$123+43%102

Lowest vs national

CodeMinnesotaNationalGapProv.
93000
Electrocardiogram complete
$18$25-28%98
22551
Arthrd ant ntrbdy cervical
$2,091$2,778-25%98
22633
Arthrd cmbn 1ntrspc lumbar
$2,281$2,991-24%98
22612
Arthrd pst tq 1ntrspc lumbar
$1,967$2,557-23%98
22558
Arthrd ant ntrbd min dsc lum
$1,909$2,471-23%98

All orthopedic surgery codes in Minnesota

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMinnesotaNationalGap% of MedicareProvidersTINsLevel
CPT 99212
Office o/p est sf 10 min
$82$51+59%137%102114
CPT 99214
Office o/p est mod 30 min
$204$132+55%150%102114
CPT 99213
Office o/p est low 20 min
$139$91+53%146%102114
CPT 99204
Office o/p new mod 45 min
$286$194+48%161%102114
CPT 99203
Office o/p new low 30 min
$175$123+43%149%102114
CPT 99205
Office o/p new hi 60 min
$357$252+41%151%102114
CPT 99215
Office o/p est hi 40 min
$256$185+38%133%102114
CPT 73564
X-ray exam knee 4 or more
$81$60+36%165%102117
CPT 73502
X-ray exam hip uni 2-3 views
$81$60+35%167%102116
CPT 73562
X-ray exam of knee 3
$71$53+34%167%102116
CPT 73030
X-ray exam of shoulder
$60$45+32%167%102117
CPT 73610
X-ray exam of ankle
$62$47+32%167%102116
CPT 26055
Incise finger tendon sheath
$800$614+30%278%102117
CPT 73560
X-ray exam of knee 1 or 2
$57$45+28%167%102116
CPT 73630
X-ray exam of foot
$57$44+28%167%102116
CPT 72100
X-ray exam l-s spine 2/3 vws
$67$53+27%167%102116
CPT 72110
X-ray exam l-2 spine 4/>vws
$89$71+26%167%102116
CPT 20610
Drain/inj joint/bursa w/o us
$104$85+22%152%102117
CPT 20550
Njx 1 tendon sheath/ligament
$90$74+22%149%102117
CPT 20611
Drain/inj joint/bursa w/us
$139$117+20%278%102117
CPT 64721
Carpal tunnel surgery
$820$700+17%170%102117
CPT 29848
Wrist endoscopy/surgery
$905$817+11%186%102117
CPT 29827
Sho arthrs srg rt8tr cuf rpr
$1,865$1,701+10%191%102117
CPT 73221
Mri joint upr extrem w/o dye
$422$387+9%206%102112
CPT 27236
Treat thigh fracture
$2,093$1,918+9%192%102117
CPT 73721
Mri jnt of lwr extre w/o dye
$421$387+9%206%102112
CPT 63047
Lam facetec & foramot lumbar
$1,952$1,796+9%183%102117
CPT 27245
Treat thigh fracture
$2,153$1,994+8%193%102117
CPT 72148
Mri lumbar spine w/o dye
$395$370+7%206%102112
CPT 97110
Therapeutic exercises
$33$31+5%113%102116
CPT 23472
Reconstruct shoulder joint
$1,840$2,318-21%141%9879
CPT 27130
Total hip arthroplasty
$1,712$2,158-21%147%9879
CPT 27447
Total knee arthroplasty
$1,711$2,190-22%148%9879
CPT 27487
Revise/replace knee joint
$2,218$2,840-22%141%9879
CPT 22558
Arthrd ant ntrbd min dsc lum
$1,909$2,471-23%134%9879
CPT 22612
Arthrd pst tq 1ntrspc lumbar
$1,967$2,557-23%134%9879
CPT 22633
Arthrd cmbn 1ntrspc lumbar
$2,281$2,991-24%134%9879
CPT 22551
Arthrd ant ntrbdy cervical
$2,091$2,778-25%130%9879
CPT 93000
Electrocardiogram complete
$18$25-28%118%9877

Frequently asked questions

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

Minnesota ranks 13th of 51 states with an index of 120; 30 of 39 codes are above the national median.

Which orthopedic surgery code has the biggest premium in Minnesota?

CPT 99212 (Office o/p est sf 10 min), at 159% 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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