Orthopedic medical billing is a complex and detail-driven process, crucial for ensuring accurate reimbursement and financial stability for orthopedic practices of all sizes. From surgical coding to insurance claim management, specialized billing expertise is essential to avoid costly errors and denials.
According to Grand View Research, the global medical billing outsourcing market was valued at over $12.2 billion in 2023 and is expected to grow at a CAGR of 12.26% through 2030—driven largely by rising administrative burdens in specialties like orthopedics.
To help orthopedic providers focus on patient care rather than paperwork, we’ve curated this list of the 10 best orthopedic medical billing companies in the USA.
These selections are based on industry reputation, client satisfaction, specialty-specific services, and compliance standards to help you choose a reliable orthopedic medical billing partner in 2025.
What is Orthopedic Billing?
Orthopedic medical billing is the process of translating orthopedic procedures, treatments, and diagnoses into standardized medical codes and submitting them to insurance companies for reimbursement.
This billing specialty focuses on musculoskeletal services such as joint replacements, fracture care, physical therapy, and spinal surgeries. It involves complex coding using CPT, ICD-10, and HCPCS systems, as well as managing prior authorizations, claim denials, and payer-specific billing rules.
10 Best Orthopedic Billing Companies in the USA
| Company Name | Orthopedic Billing Expertise | Claim Accuracy (Orthopedic) | Denial Management (Orthopedic) | Pricing Transparency | Overall Rating |
| Quality Healthcare Systems (QHS) | Extensive experience in orthopedic billing with a dedicated team | 99%+ | Robust denial tracking and appeal processes | Clear and upfront pricing | ★★★★★ |
| CareCloud | General medical billing with limited orthopedic specialization | 94% | Basic denial handling for orthopedic claims | Moderate transparency | ★★★★ |
| AdvancedMD | Ortho templates available but lacks specialty depth | 93% | Standard denial workflows | Pricing varies by features | ★★★ |
| ChartLogic | Minimal orthopedic-specific tools or coders | 91% | Limited orthopedic denial support | Transparent pricing tiers | ★★★ |
| athenahealth | Broad multispecialty billing with some orthopedic support | 92% | Structured but not specialized for orthopedics | Tiered pricing model | ★★★★ |
| DrChrono | Best for small practices, limited orthopedic focus | 90% | Reactive denial follow-ups | Clear pricing for small clinics | ★★★ |
| Promantra | Offers orthopedic billing but not a core specialization | 93% | Good AI-powered denial review | Requires custom quote | ★★★★ |
| Transcure | Handles orthopedic clients but not exclusively | 92% | Manual tracking and follow-up | Pricing upon request | ★★★ |
| Revele | Supports orthopedic billing as part of larger RCM offerings | 92% | Efficient appeal process | Variable pricing based on volume | ★★★★ |
| Medwave | Focuses on general billing; orthopedic capabilities are limited | 89% | Delayed orthopedic-specific follow-ups | Flat rate options available | ★★★ |
1. Quality Healthcare System (QHS)
- Years in Service: 15+ years
- Location: North Carolina, USA
- Website: qhshealth.com
- Email: [email protected]
- Toll Free: 1-855-QHS-5555
- Address: 602 Idol Street, Ste. 105 High Point, NC 27262
- Core Services: Orthopedic billing, provider credentialing, denial management, DME billing, ADR responses, and complete revenue cycle management.
- Pricing: Flexible plans ranging from 3% to 7% of collections, based on the service package selected.
Quality Healthcare System (QHS) is a leading and most trusted orthopedic billing company with over 15 years of specialized experience.
From small orthopedic clinics to large practices, QHS delivers customized billing solutions that drive faster payments, reduce denials, and streamline provider credentialing.
Orthopedic billing requires precision, compliance, and real-time follow-up—and QHS excels in all three.
Their dedicated team of billing experts leverages advanced tools and a proactive approach to handle every aspect of the orthopedic revenue cycle.
Whether it’s managing durable medical equipment (DME) claims, responding to additional documentation requests (ADRs), or ensuring seamless payer credentialing, QHS empowers orthopedic providers to improve cash flow while staying focused on patient care.
| Aspect | Details |
| Orthopedic Expertise | ✅ Over 15 years of experience in orthopedic billing, coding, and revenue cycle optimization. |
| Custom Billing Plans | ✅ Services tailored specifically for orthopedic practices—covering surgery billing, fracture care, joint injections, and DME claims. |
| Credentialing Support | ✅ End-to-end provider credentialing ensures faster onboarding and clean claims submission. |
| Technology Driven | ✅ Robust billing platform with real-time claims tracking, reporting, and automated follow-ups. |
| Compliance Focused | ✅ Strict adherence to orthopedic coding updates and payer policies ensures regulatory compliance. |
| Revenue Acceleration | ✅ Proven reduction in denial rates and improved reimbursement timelines for orthopedic services. |
| Initial Setup Time | ❌ Onboarding process may take time due to the detailed nature of orthopedic documentation and provider data. |
| Provider Involvement | ❌ Effective billing and credentialing require timely cooperation from the provider’s administrative team for document submission and reviews. |
2. CareCloud – Orthopedic Billing Company
- Years in Service: 15+ years
- Location: USA
- Core Services: Orthopedic billing, practice management, EHR solutions, revenue cycle management, and payer negotiations.
- Pricing: Flexible pricing based on practice size and service level.
CareCloud is a leading orthopedic billing company that offers a comprehensive suite of services to optimize the billing process for orthopedic practices. Their solutions aim to streamline revenue cycle management, reduce administrative burdens, and improve practice performance.
| Pros | Cons |
|---|---|
| ✅ Comprehensive suite of RCM services for orthopedic practices. | ❌ Higher cost, especially for smaller practices. |
| ✅ Customizable billing solutions tailored to orthopedic practices. | ❌ Integration challenges with third-party financial systems. |
| ❌ Requires substantial staff training to fully utilize the platform. | |
| ❌ Limited flexibility for orthopedic-specific needs. |
3. AdvancedMD
- Years in Service: 20+ years
- Location: USA
- Core Services: Orthopedic billing, EHR, practice management, revenue cycle management, and patient engagement tools.
- Pricing: Flexible pricing based on the size of the practice and features selected.
AdvancedMD is an orthopedic billing company providing comprehensive services that include revenue cycle management, EHR solutions, and practice management tools.
Their platform focuses on streamlining the billing and operational processes, especially for orthopedic practices, while offering a range of customizable solutions.
| Pros | Cons |
|---|---|
| ✅ Advanced practice management and billing automation for orthopedic providers. | ❌ High cost structure, particularly for smaller orthopedic practices. |
| ✅ Offers integrated tools for patient engagement and communication. | ❌ Complex setup and customization can be time-consuming. |
| ❌ Limited customer support during high-demand periods. | |
| ❌ Integration difficulties with certain third-party systems. |
4. ChartLogic
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Years in Service: 20+ years
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Location: USA
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Website: chartlogic.com
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Core Services: Orthopedic billing, EHR, practice management, and revenue cycle management.
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Pricing: Pricing varies depending on the service package and practice size.
ChartLogic is an orthopedic billing company offering tailored solutions for orthopedic practices. Their services include integrated billing, EHR systems, and practice management tools, designed to enhance the operational efficiency and revenue cycle management for orthopedic providers.
| Pros | Cons |
|---|---|
| ✅ Integrated EHR and billing solutions specifically tailored for orthopedic practices. | ❌ Setup can be time-consuming and requires a steep learning curve. |
| ✅ Customizable solutions designed for small to large orthopedic practices. | ❌ Higher cost, especially for practices with limited budgets. |
| ❌ Limited flexibility in terms of third-party integrations. | |
| ❌ Customer support may not be responsive during peak times. |
5. athenahealth
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Years in Service: 20+ years
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Location: USA
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Website: athenahealth.com
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Core Services: Orthopedic billing, EHR, revenue cycle management, and patient engagement solutions.
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Pricing: Pricing varies based on the size of the practice and the selected service package.
athenahealth is an orthopedic billing company offering comprehensive services that include orthopedic billing, EHR systems, and revenue cycle management.
They provide scalable solutions designed to streamline practice operations, optimize billing processes, and improve the patient experience in orthopedic practices.
| Pros | Cons |
|---|---|
| ✅ Scalable and flexible solutions suitable for practices of all sizes. | ❌ Higher pricing, especially for small orthopedic practices. |
| ✅ Integrated platform with billing, EHR, and patient engagement tools. | ❌ Implementation can be complex and time-consuming. |
| ❌ Limited customizability for niche orthopedic needs. | |
| ❌ Customer support can be slow during peak times. |
6. Chrono
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Years in Service: 10+ years
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Location: USA
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Website: chronohealth.com
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Core Services: Orthopedic billing, revenue cycle management, claims follow-up, and payer negotiations.
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Pricing: Custom pricing based on practice size and the chosen service package.
Chrono is an orthopedic billing company that specializes in offering solutions for revenue cycle management, claims follow-up, and payer negotiations.
Their services are designed to optimize billing efficiency and streamline practice operations for orthopedic providers, helping them reduce administrative burdens.
| Pros | Cons |
|---|---|
| ✅ Specializes in claims follow-up and payer negotiations for orthopedic practices. | ❌ Limited integration options with third-party software. |
| ✅ Customizable solutions tailored to the needs of orthopedic practices. | ❌ Pricing can be higher than other competitors, particularly for small practices. |
| ❌ Implementation process may be lengthy and complex. | |
| ❌ Customer support response time can be slow during peak periods. |
7. Promantra
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Years in Service: 15+ years
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Location: USA
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Website: promantra.com
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Core Services: Orthopedic billing, revenue cycle management, claims processing, and payer follow-up.
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Pricing: Pricing is customized based on the service level and practice size.
Promantra is an orthopedic billing company focused on providing revenue cycle management, claims processing, and payer follow-up services. Their solutions are designed to enhance billing efficiency and optimize the financial performance of orthopedic practices.
| Pros | Cons |
|---|---|
| ✅ Comprehensive revenue cycle management services tailored for orthopedic practices. | ❌ Higher pricing compared to other competitors in the orthopedic sector. |
| ✅ Efficient claims processing and payer follow-up systems. | ❌ Setup can be time-consuming and require significant customization. |
| ❌ Limited integration options with third-party platforms. | |
| ❌ Customer support can be slow during peak demand periods. |
8. Transcure
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Years in Service: 10+ years
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Location: USA
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Website: transcure.com
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Core Services: Orthopedic billing, revenue cycle management, payer follow-up, and compliance solutions.
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Pricing: Custom pricing based on services provided and practice size.
Transcure is an orthopedic billing company that offers specialized services focused on revenue cycle management, payer follow-up, and compliance. Their solutions aim to improve the financial stability and operational efficiency of orthopedic practices while ensuring compliance with industry standards.
| Pros | Cons |
|---|---|
| ✅ Focused solutions for revenue cycle management and payer follow-up for orthopedic practices. | ❌ Limited scalability for larger orthopedic practices. |
| ✅ Dedicated compliance support to ensure regulatory adherence. | ❌ Pricing is often on the higher end for smaller practices. |
| ❌ Integration with some third-party systems can be difficult. | |
| ❌ Onboarding process can be lengthy and complicated. |
9. Revele
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Years in Service: 15+ years
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Location: USA
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Website: revele.com
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Core Services: Orthopedic billing, revenue cycle management, EHR solutions, and claims management.
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Pricing: Pricing based on the selected service package and practice size.
Revele is an orthopedic billing company offering services such as revenue cycle management, EHR solutions, and claims management. Their goal is to help orthopedic practices streamline their operations, improve billing accuracy, and maximize revenue through optimized processes.
| Pros | Cons |
|---|---|
| ✅ Comprehensive billing solutions for orthopedic practices. | ❌ Limited customization options for niche orthopedic practices. |
| ✅ Integrated EHR and billing systems to streamline workflows. | ❌ Pricing may be considered high for small orthopedic practices. |
| ❌ Implementation can be slow, requiring significant training. | |
| ❌ Limited third-party software integration capabilities. |
10. Medwave
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Years in Service: 10+ years
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Location: USA
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Website: medwaveinc.com
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Core Services: Orthopedic billing, claims processing, denial management, and RCM support.
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Pricing: Pricing is based on the volume of claims and services required.
Medwave is an orthopedic billing company offering services focused on claims processing, denial management, and complete revenue cycle support. Their solutions are designed to improve cash flow and billing accuracy for orthopedic providers, with flexible service models.
| Pros | Cons |
|---|---|
| ✅ Specialized in claims and denial management for orthopedic practices. | ❌ May lack advanced technology compared to larger competitors. |
| ✅ Offers flexible RCM support for different practice sizes. | ❌ Limited reporting and analytics tools. |
| ❌ Onboarding and setup can take longer than expected. | |
| ❌ Smaller support team may affect responsiveness during peak times. |
Why QHS Is the Leading Orthopedic Billing Company in the USA
Quality Healthcare Systems (QHS) is recognized as the most reliable orthopedic billing company in the USA, trusted by practices seeking accurate, specialty-specific billing and faster reimbursement cycles.
Unlike general billing vendors, QHS is a revenue cycle management specialistwith deep experience in orthopedic billing, pharmacy billing, and billing for small practices. This unique blend allows QHS to address complex coding and compliance challenges while also catering to the operational realities of smaller orthopedic clinics.
QHS delivers full-service orthopedic billing—from insurance verification and charge entry to denial management and claims follow-up—ensuring that every claim is clean, timely, and optimized for approval. With 15+ years in the field, QHS helps orthopedic practices minimize denials and boost cash flow without adding administrative burden.
Orthopedic providers that transition to QHS often report a 30–40% drop in denials and improved payer turnaround times within the first 60 days. The result: predictable revenue, less billing stress, and a partner that understands both specialty-level complexities and small practice needs.
Reasonable and Transparent Pricing
QHS offers competitive and transparent pricing based on the level of service that best suits your practice’s needs. With pricing models tailored to different service tiers, healthcare providers can select the level of support that fits their financial goals while ensuring high-quality denial management.
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Lite Plan – 3%: Includes claim reviews for billing errors, claim transmission, front-end rejections, working on A/R and denials, and post-payment processing.
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Premium Plan – 5%: Adds custom billing reports and 1 login for software, in addition to all features of the Lite plan.
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Premium+ Plan – 7%: Offers additional features like patient invoicing, pre/post-pay audit assistance, and 2 logins for software.
See How QHS Transforms Revenue for Healthcare Providers
Read real success stories from our clients and discover how QHS helped them boost collections and streamline operations. [Explore Success Stories →]
Other Services Quality Healthcare Systems Provides:
A/R Management | Revenue Cycle Management | Denial Management
How to Choose a Reliable Orthopedic Billing Service in the USA
Look for an orthopedic billing service with specialty-specific expertise, strong denial management, transparent pricing, and experience in handling small practice workflows. Ensure they offer full revenue cycle management and stay updated with orthopedic coding and payer policies.
Quality Healthcare Systems (QHS) stands out with 15+ years of orthopedic billing experience, offering tailored support, faster reimbursements, and reliable claims management. QHS combines specialty focus with scalable solutions for both large and small orthopedic practices across the USA.
Frequently Asked Questions
What does an orthopedic billing company do?
An orthopedic billing company manages the complete billing process for orthopedic practices, including insurance verification, medical coding (CPT, ICD-10), claims submission, denial management, and payment posting. Their goal is to ensure faster reimbursements and fewer claim rejections.
How do orthopedic billing services help reduce claim denials?
Orthopedic billing services reduce claim denials by using accurate specialty coding, verifying patient coverage, and identifying billing errors before submission. They also follow up on denied claims quickly to maximize recovery and maintain consistent cash flow.
Why should small practices use orthopedic billing companies?
Small orthopedic practices benefit from outsourcing billing to specialists who understand complex orthopedic codes and payer rules. It reduces administrative burden, speeds up reimbursements, and allows the practice to focus on patient care rather than back-office tasks.
How is orthopedic billing different from general medical billing?
Orthopedic billing involves more complex coding, surgical modifiers, and durable medical equipment (DME) charges than general medical billing. It requires a deep understanding of musculoskeletal procedures and payer-specific requirements for successful claim processing.
What should I look for in an orthopedic billing company?
Look for an orthopedic billing company with experience in your specialty, a proven track record of lowering denials, transparent pricing, and full revenue cycle management services. Also, confirm they stay up to date with orthopedic coding and payer regulations..
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