Orthopedics Accounting

Six surgeons, an ASC, a PT clinic, and imaging. One set of books that explains nothing.

Orthopedic practices are multi-entity businesses. We give you the financial clarity to manage each one, and the whole picture.

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A 4-minute test your accountant hopes you skip.

At a glance

Investment$3,000–$4,000/mo
Contract1-year, billed monthly
Setup$3,000–$9,000 onboarding
IncludesMulti-entity P&Ls, implant tracking, partner production

Is This Right for You?

This service is for orthopedic practice owners who recognize these problems:

You have ancillary revenue from imaging, PT, and DME but cannot tell if those departments are actually profitable or just convenient
Implant costs are eating your surgical margins and you have no system to track cost per case against reimbursement
Workers comp cases bring good revenue but the billing lag makes your cash flow unpredictable and your books inaccurate
Your ASC or surgery center share generates income but the financial statements from the management company are confusing
You have 6 surgeons with different subspecialties and production levels. Partnership distributions feel unfair but nobody has the data to prove it

Need strategic financial leadership? Our Fractional CFO service for orthopedic practices may be a better fit.

What's Included

How We Work With Orthopedic Practices

Orthopedics-specific accounting that goes beyond reconciliation.

01

Ancillary Department Economics

  • Imaging (MRI, X-ray) department P&L with equipment and staffing costs
  • Physical therapy department profitability analysis
  • DME margin tracking (purchase cost vs billing vs collection)
  • Cross-referral revenue tracking between departments
02

Surgical Case Economics

  • Per-case implant cost tracking by procedure and vendor
  • Surgeon-specific case cost and revenue analysis
  • ASC vs hospital case profitability comparison
  • Global period revenue impact analysis
03

Partner Production & Compensation

  • Production tracking by surgeon and subspecialty
  • Compensation formula analysis and fairness review
  • Ancillary revenue allocation methodology
04

Workers Comp & PI Revenue

  • Workers comp receivable aging and collection tracking
  • Personal injury case financial tracking
  • Payer-specific reimbursement analysis
  • Cash flow impact of delayed payments

Results

What Orthopedic Practices Experience

MetricTypical Outcome
Implant cost savings$186,000 annually through vendor renegotiation and standardization
DME revenue recovered$73,000 from billing process corrections
PT department improvement4% to 13% margin through productivity optimization, adding $108K annually

Case Study

See The System In Action

6-surgeon orthopedic group with ASC ownership, in-house PT, imaging center, and DME dispensing. Total revenue across all entities was $11.4M, but partner take-home had declined 15% over three years. The partners suspected declining reimbursements but the real problems were operational.

What we found:

  • Implant costs had increased 22% over three years without any vendor renegotiation. $186K in annual savings was available through competitive bidding and standardization
  • The PT department was operating at a 4% margin instead of the 12 to 15% benchmark because three of the six PTs were averaging only 8.5 visits per day against a target of 11
  • DME was dispensed on 35% of eligible visits but billed on only 22%. The 13% gap represented $73K in missed annual revenue
  • Global surgery period coding errors meant the practice was leaving $117K per year in separately billable post-surgical services uncollected

The results

$186,000 annually through vendor renegotiation and standardization

Implant cost savings

$73,000 from billing process corrections

DME revenue recovered

4% to 13% margin through productivity optimization, adding $108K annually

PT department improvement

We were blaming the insurance companies for our declining income. Turns out we had $350K sitting in our own operations that we were not collecting.

Managing Partner, South

Common Questions About Accounting for Orthopedic Practices

Don't pay for reports. Pay for progress.

Take the 4-minute financial assessment—and find out if your books are helping or hurting your orthopedic practice.

Take the Free Financial Assessment →

The test your accountant hopes you skip.