Rette Insights

Orthopedic billing, coding and RCM guides

Practical answers to the revenue-cycle questions orthopedic practices ask most: modifiers and coding rules, denials and appeals, prior authorization, workers’ comp and the benchmarks that matter. Every guide cites its sources and shows when it was last updated.

Looking for a quick definition? Browse the Reference library →

Featured guide

Calculator and pen on a printed statement, representing Medicare physician payment math

CY2027 Medicare Physician Fee Schedule: What It Means for Orthopedic Practices

CMS’s proposed 2027 fee schedule cuts the conversion factor, joint replacement RVUs and same-day E/M pay. What orthopedic practices should do now.

Oct 14, 2026

Medicare & Payer Updates

CY2027 Medicare Physician Fee Schedule: What It Means for Orthopedic Practices

Oct 14, 2026

All guides

Medicare & Payer Updates

Coding & Modifiers

Denials & Appeals

Prior Authorization

Workers’ Comp & Ancillary Services

RCM Benchmarks & Strategy

Surgical team performing an operation in a bright operating room

Denials & Appeals

How to Appeal a Medical-Necessity Denial for a Knee or Hip Replacement

Oct 14, 2026

Magnifying glass on a printed document, representing claim denial review

Denials & Appeals

The Most Common Orthopedic Claim Denials in 2026, and How to Prevent Them

Oct 14, 2026

Medicare & Payer Updates

CY2027 Medicare Physician Fee Schedule: What It Means for Orthopedic Practices

Oct 14, 2026

Doctor typing on a keyboard with a stethoscope nearby

RCM Benchmarks & Strategy

In-House vs. Outsourced vs. AI-Automated Billing for Orthopedic Practices (2026)

Oct 14, 2026

Doctor examining a patient's leg during an orthopedic office visit

Coding & Modifiers

Can You Bill an E/M With Modifier 25 on an Orthopedic Injection Day?

Oct 14, 2026

Performance analytics graphs on a laptop screen

RCM Benchmarks & Strategy

Orthopedic RCM Benchmarks for 2026: Days in A/R, Clean Claim Rate, Denial Rate and Net Collection Rate

Oct 14, 2026

Two construction workers in safety vests at a job site

Workers’ Comp & Ancillary Services

Orthopedic Workers’ Compensation Billing: Authorizations, Fee Schedules and Common Denials

Oct 14, 2026

Prior Authorization

WISeR Model: Which Orthopedic Services Need Medicare Prior Authorization?

Oct 14, 2026

Reference library

Look up a modifier, denial code or RCM metric

Short, sourced definitions written for orthopedic practices: what each term means, why claims get denied over it and how to prevent it.

Browse all terms

Advance Beneficiary Notice (ABN)

CARC CO-11

CARC CO-16

CARC CO-197

CARC CO-4

CARC CO-50

CARC CO-97

Clean claim rate

CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)

Days in A/R

Denial rate

Global surgical package

HCPCS G2211

Medically Unlikely Edits (MUEs)

Modifier 24

Modifier 25

Modifier 57

Modifier 58

How we write these guides

Each guide answers the question first, cites primary sources such as CMS, the NCCI manual, payer policies and state workers’ comp agencies, and shows the date it was last updated. Content is reviewed by the Rette revenue cycle team, written for orthopedic practices, and is educational rather than legal or billing advice.

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