Orthopedic surgery · Nebraska

Orthopedic surgery commercial reimbursement in Nebraska

How Nebraska orthopedic surgery rates compare with the national market.

Orthopedic surgery in Nebraska

39 codes · 95 sampled providers
Index vs national
135
35% above
Rank among states
5 of 51
1 = highest
Codes above national
39 of 39
median code at 135%
Providers
95
sampled

What the data shows

1

Orthopedic surgery ranks 5th of 51 states in Nebraska with an index of 135 (100 = the specialty's national median), across 39 codes and 95 sampled providers.

2

Of the 39 orthopedic surgery codes with enough data in Nebraska, 39 pay above the national median and 0 below; the typical code sits at 135% of the national median.

3

Largest premium over the national median: CPT 26055 (Incise finger tendon sheath) at 160%; largest discount: CPT 72148 (Mri lumbar spine w/o dye) at 107%.

4

Measured against Medicare, Nebraska orthopedic surgery rates have a median of 198% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeNebraskaNationalGapProv.
26055
Incise finger tendon sheath
$980$614+60%95
20611
Drain/inj joint/bursa w/us
$181$117+56%95
73502
X-ray exam hip uni 2-3 views
$93$60+54%95
73564
X-ray exam knee 4 or more
$92$60+54%95
73610
X-ray exam of ankle
$72$47+54%95

Lowest vs national

CodeNebraskaNationalGapProv.
72148
Mri lumbar spine w/o dye
$396$370+7%95
73721
Mri jnt of lwr extre w/o dye
$418$387+8%95
73221
Mri joint upr extrem w/o dye
$419$387+8%95
27130
Total hip arthroplasty
$2,546$2,158+18%95
93000
Electrocardiogram complete
$31$25+21%95

All orthopedic surgery codes in Nebraska

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNebraskaNationalGap% of MedicareProvidersTINsLevel
CPT 26055
Incise finger tendon sheath
$980$614+60%341%95103
CPT 20611
Drain/inj joint/bursa w/us
$181$117+56%362%95103
CPT 73502
X-ray exam hip uni 2-3 views
$93$60+54%191%95101
CPT 73564
X-ray exam knee 4 or more
$92$60+54%186%95101
CPT 73610
X-ray exam of ankle
$72$47+54%195%95101
CPT 99215
Office o/p est hi 40 min
$282$185+53%147%95103
CPT 73630
X-ray exam of foot
$68$44+52%198%95101
CPT 73562
X-ray exam of knee 3
$80$53+52%189%95100
CPT 73560
X-ray exam of knee 1 or 2
$68$45+51%196%95101
CPT 72100
X-ray exam l-s spine 2/3 vws
$79$53+49%196%95101
CPT 73030
X-ray exam of shoulder
$67$45+48%187%95101
CPT 99213
Office o/p est low 20 min
$134$91+48%140%95103
CPT 20550
Njx 1 tendon sheath/ligament
$108$74+46%178%95103
CPT 99214
Office o/p est mod 30 min
$191$132+45%141%95103
CPT 72110
X-ray exam l-2 spine 4/>vws
$102$71+44%190%95101
CPT 97110
Therapeutic exercises
$45$31+42%154%95102
CPT 20610
Drain/inj joint/bursa w/o us
$120$85+41%175%95103
CPT 99205
Office o/p new hi 60 min
$354$252+40%150%95103
CPT 99212
Office o/p est sf 10 min
$71$51+39%120%95103
CPT 99204
Office o/p new mod 45 min
$261$194+35%147%95103
CPT 99203
Office o/p new low 30 min
$164$123+33%139%95103
CPT 27236
Treat thigh fracture
$2,557$1,918+33%235%95101
CPT 27487
Revise/replace knee joint
$3,719$2,840+31%236%95100
CPT 64721
Carpal tunnel surgery
$914$700+31%189%95103
CPT 27245
Treat thigh fracture
$2,595$1,994+30%232%95102
CPT 22558
Arthrd ant ntrbd min dsc lum
$3,204$2,471+30%225%95101
CPT 22612
Arthrd pst tq 1ntrspc lumbar
$3,294$2,557+29%224%95101
CPT 27447
Total knee arthroplasty
$2,771$2,190+27%239%95100
CPT 22633
Arthrd cmbn 1ntrspc lumbar
$3,785$2,991+27%223%95101
CPT 29848
Wrist endoscopy/surgery
$1,033$817+27%213%95101
CPT 63047
Lam facetec & foramot lumbar
$2,267$1,796+26%213%95101
CPT 29827
Sho arthrs srg rt8tr cuf rpr
$2,144$1,701+26%220%95102
CPT 22551
Arthrd ant ntrbdy cervical
$3,499$2,778+26%218%95100
CPT 23472
Reconstruct shoulder joint
$2,910$2,318+26%224%95101
CPT 93000
Electrocardiogram complete
$31$25+21%200%9599
CPT 27130
Total hip arthroplasty
$2,546$2,158+18%219%9599
CPT 73221
Mri joint upr extrem w/o dye
$419$387+8%204%95101
CPT 73721
Mri jnt of lwr extre w/o dye
$418$387+8%205%95101
CPT 72148
Mri lumbar spine w/o dye
$396$370+7%206%95101

Frequently asked questions

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

Nebraska ranks 5th of 51 states with an index of 135; 39 of 39 codes are above the national median.

Which orthopedic surgery code has the biggest premium in Nebraska?

CPT 26055 (Incise finger tendon sheath), at 160% 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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