• Specialty billing guide Orthopedics

Orthopedic billing: global periods, injection modifiers, and assistant surgeon rules.

Last updated: August 2026

THE BOTTOM LINE

Orthopedics stacks more billable events into one episode of care than almost any other outpatient specialty: an office visit, imaging, an injection, a cast, DME, and possibly a 90-day global package, all for the same patient inside a short window. Every one of those has a bundling relationship with the others.

The denials concentrate in three places: E/M visits inside a global period, joint injections billed with a same-day visit, and assistant surgeon claims on codes that were never going to pay an assistant.

That last one has a rule most reference material states backward, and it is worth reading carefully because getting it wrong means either denied claims or a case booked with an assistant who cannot be paid.

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