Orthopedic surgery · South Dakota

Orthopedic surgery commercial reimbursement in South Dakota

How South Dakota orthopedic surgery rates compare with the national market.

Orthopedic surgery in South Dakota

39 codes · 97 sampled providers
Index vs national
138
38% above
Rank among states
4 of 51
1 = highest
Codes above national
39 of 39
median code at 137%
Providers
97
sampled

What the data shows

1

Orthopedic surgery ranks 4th of 51 states in South Dakota with an index of 138 (100 = the specialty's national median), across 39 codes and 97 sampled providers.

2

Of the 39 orthopedic surgery codes with enough data in South Dakota, 39 pay above the national median and 0 below; the typical code sits at 137% of the national median.

3

Largest premium over the national median: CPT 73502 (X-ray exam hip uni 2-3 views) at 154%; largest discount: CPT 99212 (Office o/p est sf 10 min) at 107%.

4

Measured against Medicare, South Dakota orthopedic surgery rates have a median of 201% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeSouth DakoNationalGapProv.
73502
X-ray exam hip uni 2-3 views
$93$60+54%97
73564
X-ray exam knee 4 or more
$92$60+54%97
73560
X-ray exam of knee 1 or 2
$69$45+53%97
73610
X-ray exam of ankle
$71$47+52%97
73562
X-ray exam of knee 3
$80$53+52%97

Lowest vs national

CodeSouth DakoNationalGapProv.
99212
Office o/p est sf 10 min
$55$51+7%97
99213
Office o/p est low 20 min
$103$91+14%97
99214
Office o/p est mod 30 min
$151$132+15%97
99215
Office o/p est hi 40 min
$214$185+16%97
99203
Office o/p new low 30 min
$144$123+17%97

All orthopedic surgery codes in South Dakota

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeSouth DakotaNationalGap% of MedicareProvidersTINsLevel
CPT 73502
X-ray exam hip uni 2-3 views
$93$60+54%190%9796
CPT 73564
X-ray exam knee 4 or more
$92$60+54%186%9795
CPT 73560
X-ray exam of knee 1 or 2
$69$45+53%199%9796
CPT 73610
X-ray exam of ankle
$71$47+52%193%9796
CPT 73562
X-ray exam of knee 3
$80$53+52%189%9796
CPT 73630
X-ray exam of foot
$67$44+51%197%9796
CPT 73030
X-ray exam of shoulder
$67$45+48%187%9796
CPT 72100
X-ray exam l-s spine 2/3 vws
$78$53+47%193%9797
CPT 72110
X-ray exam l-2 spine 4/>vws
$101$71+44%190%9797
CPT 23472
Reconstruct shoulder joint
$3,298$2,318+42%254%9793
CPT 29848
Wrist endoscopy/surgery
$1,161$817+42%239%9795
CPT 29827
Sho arthrs srg rt8tr cuf rpr
$2,412$1,701+42%247%9796
CPT 27236
Treat thigh fracture
$2,707$1,918+41%248%9796
CPT 27487
Revise/replace knee joint
$3,984$2,840+40%253%9792
CPT 27245
Treat thigh fracture
$2,785$1,994+40%249%9795
CPT 64721
Carpal tunnel surgery
$969$700+38%201%9796
CPT 22558
Arthrd ant ntrbd min dsc lum
$3,416$2,471+38%240%9794
CPT 97110
Therapeutic exercises
$43$31+38%149%9795
CPT 22612
Arthrd pst tq 1ntrspc lumbar
$3,524$2,557+38%240%9794
CPT 27130
Total hip arthroplasty
$2,967$2,158+37%255%9793
CPT 22633
Arthrd cmbn 1ntrspc lumbar
$4,088$2,991+37%240%9792
CPT 22551
Arthrd ant ntrbdy cervical
$3,766$2,778+36%235%9793
CPT 27447
Total knee arthroplasty
$2,960$2,190+35%255%9793
CPT 63047
Lam facetec & foramot lumbar
$2,427$1,796+35%228%9797
CPT 93000
Electrocardiogram complete
$32$25+27%209%9793
CPT 99205
Office o/p new hi 60 min
$319$252+27%135%9795
CPT 99204
Office o/p new mod 45 min
$244$194+26%138%9795
CPT 20550
Njx 1 tendon sheath/ligament
$91$74+24%151%9796
CPT 73221
Mri joint upr extrem w/o dye
$478$387+24%233%9795
CPT 73721
Mri jnt of lwr extre w/o dye
$477$387+23%233%9795
CPT 20610
Drain/inj joint/bursa w/o us
$105$85+23%153%9797
CPT 72148
Mri lumbar spine w/o dye
$449$370+21%234%9795
CPT 20611
Drain/inj joint/bursa w/us
$140$117+20%280%9796
CPT 26055
Incise finger tendon sheath
$734$614+20%255%9796
CPT 99203
Office o/p new low 30 min
$144$123+17%122%9795
CPT 99215
Office o/p est hi 40 min
$214$185+16%111%9796
CPT 99214
Office o/p est mod 30 min
$151$132+15%112%9795
CPT 99213
Office o/p est low 20 min
$103$91+14%108%9795
CPT 99212
Office o/p est sf 10 min
$55$51+7%93%9795

Frequently asked questions

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

South Dakota ranks 4th of 51 states with an index of 138; 39 of 39 codes are above the national median.

Which orthopedic surgery code has the biggest premium in South Dakota?

CPT 73502 (X-ray exam hip uni 2-3 views), at 154% 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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