How is implant hardware billed and tracked?

At the point of implantation, our system captures the implant lot number, manufacturer, and unit cost, automatically generating the corresponding facility charge and linking it to the operative claim, so plates, screws, rods, and joint components are never left off the bill.

What is the difference between fracture care codes and casting/strapping codes, and how does the system handle this?

Fracture care codes (e.g., 25600 for distal radius fracture treatment) include a global period covering related follow-up care and cast changes, while standalone casting/strapping codes (29000 series) are used when casting is performed without comprehensive fracture management. Our charge engine determines which applies based on the documented level of physician involvement and prevents double-billing of cast supplies already bundled into fracture care codes.

How does the platform sequence modifiers for bilateral knee or hip procedures?

For bilateral procedures performed in the same session, our engine automatically applies modifier-50 or the appropriate -RT/-LT pairing per payer preference, while sequencing additional procedure modifiers (-51, -59) on secondary procedures in the order that maximizes correct reimbursement under each payer's multiple procedure reduction rules.

Can the system manage assistant surgeon billing?

Yes. When an assistant surgeon participates in a case, the system generates a separate claim with modifier-80, -81, or -82 as appropriate, linked to the primary surgeon's claim, and tracks payer-specific assistant surgeon eligibility rules by procedure code.

How are durable medical equipment items like braces and walking boots billed after surgery?

Post-operative DME items dispensed in-office, such as knee immobilizers, walking boots, and slings, are captured at checkout and billed under the correct HCPCS L-codes with documentation of medical necessity, separate from the surgical global package.

Does the system support workers' compensation orthopedic claims?

Yes. Orthopedic practices treating work-related injuries can route claims through state-specific workers' compensation fee schedules, which often differ significantly from standard payer rates, with the system automatically applying the correct fee schedule based on the claim's jurisdiction.

How does the platform handle billing for spinal fusion procedures with multiple levels?

Multi-level spinal fusion billing requires correct add-on code usage for each additional vertebral level or interspace. Our engine automatically generates the primary fusion code plus the correct number of add-on codes based on the documented levels, while applying instrumentation and bone graft codes per payer bundling rules.

Orthopedics PM & RCM Software

Practice Management and RCM Billing Built for Orthopedics

Master global surgical periods, implant tracking, and fracture care coding sequences. See why orthopedics practices choose Unlimited Systems for practice management and RCM software.

Why Orthopedics billing is different

Orthopedic surgery practices manage some of the highest-value procedures in outpatient medicine, from joint replacements with 90-day global periods to same-day fracture reductions and hardware implantation. Generic RCM platforms routinely bill follow-up visits that fall inside a global surgical period, fail to capture implant costs separately, and misorder modifiers on multi-procedure operative sessions, each of which directly erodes surgical margins.

When a patient returns for a post-operative visit within the 90-day global period of a total knee replacement, that visit is typically bundled into the surgical payment and cannot be billed separately unless it addresses an unrelated condition with modifier-24 or -79. At the same time, the hardware implanted during surgery, plates, screws, rods, must be tracked by lot number and billed correctly to the facility, while the surgeon's claim must sequence multiple procedure modifiers (-51, -59, -RT/-LT) precisely or risk a cascade of denials across the entire operative claim.

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6,500+ specialty providersSOC 2 certified

Surgical team at work in an operating room

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Orthopedics workspace preview coming soon

HOME SPECIALTIESOrthopedic Surgery RCM Software

Trusted Payer & EHR Integration Partners

Designed Around How Your Orthopedics Practice ACTUALLY Works

Our connected workflows are built to make you and your work easier to do and increase your revenue.

Visit-ready

Keep authorization and coverage aligned before the appointment is booked.

Claim-ready

Validate orthopedics codes, modifiers, and documentation before submission.

Practice-ready

Give teams one view of denials, margin, and A/R priorities.

Specialty RCM intelligence

Orthopaedics Revenue Cycle Challenges

Global periods, modifier complexity, and implant billing drive high surgical coding error rates.

17%

Est. denial rate

8/10

Prior-auth burden

Where revenue is at risk

Global Surgical Period Billing

Major procedures such as TKA and THA carry 90-day global periods; services outside the global period require modifier 24 or 79 support.

How the platform addresses this

Global-period rules are applied to every post-op encounter.
Separately billable visits are identified with the correct modifier.
Bundled follow-up stops being written off by default.

See it on your own claims

Buy-and-bill drug reference5 agents · codes, channel, prior-auth, and billing notes

Drug	Code	Route	Channel	Cost	PA	Billing notes
Synvisc / Synvisc-One	J7325	Intra-articular	Part B	$700-$900/series	Sometimes	Per-mg billing; EJ modifier for subsequent series injections; JW required.
Euflexxa (sodium hyaluronate)	J7323	Intra-articular	Part B	$600-$800/series	Sometimes	Bilateral equals 2 units on same line; RT/LT required on CPT 20610.
Durolane (sodium hyaluronate)	J7318	Intra-articular	Part B	$400-$600/injection	Yes	Single-injection product; some commercial payers exclude.
Zilretta (triamcinolone ER)	J3303	Intra-articular	Part B	$600/injection	Yes	Extended-release steroid; single-use; JW required.
Cortisone / Triamcinolone	J3301	Intra-articular/IM	Part B	$20-$50/injection	No	Multi-dose vial; ultrasound guidance billed separately if used.

Cabinet integration: Orthopaedic practices performing in-office joint injections need per-dose and per-mg J-code accuracy. Without cabinet integration, Synvisc unit-count errors and missing EJ/JW modifiers are common drug-related denial triggers.

Real Orthopedics Practices, Real Results

See how orthopedics groups across the country use Unlimited Systems to lift collections, cut denials, and reclaim staff time.

Featured Practice

Orthopedics Partners of the Midwest

Columbus, OH14-provider group practice

“Unlimited Systems gave our orthopedics billing team the specialty-specific automation we could never get from a generic platform. First-pass claim acceptance climbed fast.”

- Director of Revenue Cycle

23%

Fewer denials

11 days

Faster A/R

Calculate Your RCM Revenue Leakage

Drag the sliders to estimate how much unrealized cash remains locked in your current specialty billing cycles before optimization.

Model your current claim volume

Adjust both inputs to match your practice.

Monthly specialty claims1,500

200 claims15,000 claims

Average claim value$250

$80 value$3,500 value

Estimated annual revenue recovered

$315,000

Calculated using a 7.0% reduction in write-offs from rejection recovery, pre-authorization verification, and drug-waste capture.

Monthly invoiced volume: $375,000
Standard industry loss: $31,875

Unlimited Systems Guarantee: Fully integrated bi-directional EHR triggers maintain first-pass bill submission scores above 98.6% across regional payer rules on day one.

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See your recovery estimate

Enter your work email to unlock your estimated annual recovery.

See Your Results Immediately5/55/54.8/5

One platform for every orthopedics workflow

Eight connected capabilities, grouped around the way your practice works.

Front office

Keep registration and appointment calendars in sync.

Patient intake Scheduling

Before the visit

Verify coverage and catch charge risk early.

Financial clearance Charge validation

Revenue cycle

Post payments, route denials, and prioritize A/R.

Payment and denials A/R management

Practice intelligence

See margin, performance, and value-based results.

Analytics Value-based care

The Orthopedics suite

Every part of the orthopedics revenue cycle, in one system

Each module is configured for the codes, modifiers, and payer rules orthopedics teams work with, not adapted from generic billing software.

Orthopedics Patient Intake SoftwareCapture insurance details and benefit verification for scheduled surgical cases before pre-op clearance.Orthopedics Scheduling SoftwareCoordinate operating room blocks, casting clinic visits, and global-period follow-ups on a unified calendar.Orthopedics Financial Clearance SoftwareVerify and track prior authorizations for joint replacements, arthroscopies, and spinal procedures.Orthopedics Charge Validation SoftwareAutomatically flag bundled global-period visits and capture implant hardware charges by lot number.Orthopedics Payment Posting SoftwarePost complex bundled surgical remittances across surgeon, assistant surgeon, and facility claims.Orthopedics AR Management SoftwareResolve denials caused by incorrect multiple-procedure or laterality modifier sequencing on operative claims.Orthopedics Analytics SoftwareAnalyze net margins per procedure type, implant cost recovery rate, and global period leakage.Orthopedics Value-Based Care SoftwareTrack total cost of care for joint replacement episodes under CMS bundled payment models like CJR.

The cost of generic billing

You went into orthopedics to treat patients, not to chase claims

These are the places orthopedics practices most often lose revenue when their billing platform wasn’t built for the work. Unlimited Systems closes each one with rules configured for your specialty.

Review your workflow

Common orthopedics revenue leaks

Inappropriate billing of evaluation and management visits that fall within 10-day or 90-day global surgical periods.
Lost revenue from unbilled or undocumented implantable hardware (plates, screws, rods, joint components).
Confusion between fracture care codes (with their own global periods) and simple casting/strapping codes.
Multiple procedure modifier sequencing errors on bilateral or multi-site operative sessions causing payment reductions.

Challenges we solve for orthopedics

The work that generic platforms leave to your staff is the work orthopedics margin actually turns on.

Global Period Management

System automatically flags any visit falling within an active global period and applies the correct -24/-79 modifier logic only when justified.

Implant Hardware Billing

Implant scanning at the point of use automatically generates the correct facility charge tied to lot and serial number.

Multi-Procedure Modifier Sequencing

Engine ranks procedures by relative value and applies -51, -59, and laterality modifiers in the correct payer-specific order.

Legacy software vs. Unlimited Systems

See why orthopedics practices move off general-purpose billing platforms.

CRITERIA

LEGACY SYSTEM COMPROMISE

UNLIMITED SYSTEMS VALUE

Global Period Management

✕Billing systems do not track active global periods, resulting in bundled visits being billed and later recouped.

✓System automatically flags any visit falling within an active global period and applies the correct -24/-79 modifier logic only when justified.

Implant Hardware Billing

✕Hardware costs are tracked manually or not at all, leaving thousands in implant revenue uncaptured.

✓Implant scanning at the point of use automatically generates the correct facility charge tied to lot and serial number.

Multi-Procedure Modifier Sequencing

✕Bilateral and multi-site procedures are billed in arbitrary order, triggering payment reductions or denials.

✓Engine ranks procedures by relative value and applies -51, -59, and laterality modifiers in the correct payer-specific order.

Still evaluating

Not Ready to Switch Yet? That's Exactly When to Start the Conversation.

You don't have to be actively replacing your current system to have a useful conversation with Unlimited Systems. Many orthopaedics practices talk with us months before a contract renewal or system evaluation to understand where global periods, laterality, modifier accuracy, DME, and prior authorization for procedures may already be showing up.

Get a Demo Benchmark Your Current Workflow

A conversation can help identify where global-period billing, LT/RT laterality, modifier 24/79/59 accuracy, implant and DME coding, and total-joint or spinal-fusion authorizations may be driving preventable denials.

Less billing work between the visit and payment

Specialty rules and connected data keep your team focused on the exceptions that need judgment.

Verify before the visit

Coverage and authorization stay tied to the order.

Validate specialty charges

Code, unit, and modifier checks happen before filing.

Work the right accounts

Denials and A/R are ranked by value and filing risk.

Care team in scrubs walking through a clinic corridor

35%less manual workflow time

One platform

The rest of the platform your orthopedics practice runs on

The same connected system handles the operational work that sits either side of billing.

Patient Intake

Digital intake, eligibility, and demographic capture before the visit.

Explore Patient Intake

Patient Scheduling

Smart calendars and resource scheduling across providers and locations.

Explore Patient Scheduling

Financial Clearance

Automated eligibility checks and prior authorization management.

Explore Financial Clearance

Charge Validation

Pre-claim scrubbing for coding, modifiers, and compliance accuracy.

Explore Charge Validation

Built for orthopedics

Follow one orthopedics patient from intake to payment

Eight stages, one record. Nothing is rekeyed between systems, so a detail captured at the front desk is still there when the claim goes out, and when the remittance comes back.

Walk the workflow with us

Frequently asked questions

Every surgical procedure code is mapped to its CMS-assigned global period (0, 10, or 90 days). The system automatically calculates the active global window from the date of surgery and flags any subsequent visit, preventing inappropriate E/M billing unless modifier-24 (unrelated condition) or modifier-79 (unrelated procedure) documentation supports separate billing.

New to revenue cycle terminology? Browse our healthcare RCM & billing glossary.

We Love Hearing From Our Users

Practices like yours, on what changed after moving to Unlimited Financials.

EXPLORE PRODUCTS GET A DEMO

★★★★★4.8/5

★★★★★5/5

“

I'd love to set up a call to talk about SCOA, and the success we've had with Unlimited Financials.

Sam Wheeler

CFO, SCOA

“

The system continues to grow with features as it should, with how healthcare changes. So, if you are looking for a company that is innovative and truly cares, I would recommend Unlimited Financials.

Ernelita Dacumos

Billing Manager, SHOM

“

Unlimited Financials has been the easiest and best practice management system I have used. It is easy to navigate and do what I need to do.

Melissa Shook

Medical Biller, SHOM

“

I would recommend Unlimited Financials to other specialty practices.

Michelle Leandri

CEO, NEPA

“

We transitioned to Unlimited Financials in 2024... the team and platform are absolutely amazing.

Gina

Administrator, FOUR

“

We have been on Unlimited Financials for over three years and love it. Our claims are being processed faster and more efficiently, which means we are receiving payment more quickly.

Renee Bernacchi

Accounts Receivable Coordinator, COAS

“