●  Orthopedic Groups  ●

Operating leverage for orthopedic practices

Orthopedics has more revenue levers than almost any specialty — surgical mix, imaging, therapy, DME, ASC ownership. That’s also why undermanaged orthopedic groups leave more on the table than anyone else.

Sound Familiar?

Complexity is the tax on orthopedic profitability

Ancillaries running on autopilot

MRI, PT, DME, and bracing lines each have their own economics, compliance rules, and leakage points — and in many groups nobody owns any of them.

Clinic and OR fighting for the same hours

Surgeon time is the scarcest asset in the building. Template design, case sequencing, and first-case starts decide whether it compounds or evaporates.

Partners with different books

Productivity-based compensation without clean data and agreed governance turns every partner meeting into an argument about numbers no one trusts.

●  Two Ways to Engage  ●

Same executive expertise. Two engagement models.

Both engagements bring senior healthcare-executive expertise to your orthopedic group. The difference is the number of hours per week your outside expert is involved — and who executes the plan.

Fractional Executive

We lead it with your team

A COO, CFO, or CEO-level operator embedded in your practice on a weekly cadence — running leadership meetings, working directly with your staff, and owning outcomes. Executive-caliber leadership at roughly 20–30% of the cost of a full-time hire.

Consulting

We build it, you run it

A focused engagement built around analysis and a clear, prioritized roadmap. Often the better value when you already have the leadership in place to execute a well-built plan — project-based, defined scope, defined deliverables.

How We Work

Five steps. Every engagement.

Every engagement — fractional or consulting, any specialty — follows the same five-step operating discipline.

1
Assess
2
Prioritize
3
Execute
4
Develop
5
Measure

Where We Focus

What we work on inside orthopedic groups

Aligning the clinical engine, the ancillary portfolio, and the partnership economics — with data everyone can trust.

  Ancillary line management

Contribution-margin reporting and dedicated ownership for imaging, therapy, DME, and injections — run as businesses, compliant with Stark/AKS in-office rules.

  Surgical scheduling & throughput

Clinic templates that feed the OR, block utilization, first-case on-time starts, and case-cost visibility by procedure and payer.

  Payer contracting

Rate benchmarking, bundle and episode strategy, and negotiation leverage built from your own outcome and cost data.

  Partnership economics

Compensation-plan design, overhead allocation methodology, and governance rhythms that keep partner alignment ahead of partner disputes.

  ASC strategy

Feasibility, syndication, and utilization economics for surgery-center ownership — modeled honestly against your case mix and payer contracts.

  Revenue cycle at orthopedic scale

Surgical coding accuracy, implant and supply cost capture, denial management, and AR discipline on high-dollar episodes.

“An orthopedic group is five businesses sharing a lobby. Each one deserves a P&L, an owner, and a plan.”

Questions

Frequently asked questions

How can an orthopedic practice increase ancillary revenue compliantly?
Start with the in-office ancillary services framework under Stark law and structure each line - imaging, PT, DME - to meet it, with legal counsel on the details. Then manage each ancillary as a business: its own volume, margin, and leakage metrics, with a named owner. Most groups find their biggest gains not in adding new ancillaries but in capturing referrals already written that currently leak outside the practice.
Should our orthopedic group invest in an ASC?
ASC ownership can be one of the strongest economic moves in orthopedics as cases migrate outpatient - but the model depends on your case mix, payer contracts, state regulations, and realistic utilization commitments from partners. We build the feasibility model, stress-test it, and help structure governance so the ASC strengthens the group rather than dividing it.
How should an orthopedic group structure partner compensation?
Most groups land on productivity-based models (collections or wRVU) with deliberate handling of ancillary income, call coverage, and overhead allocation - the three flashpoints. The mechanics matter less than the data integrity and governance behind them: agreed definitions, transparent monthly reporting, and a documented methodology that doesn't reopen with every partner meeting.
Do you replace our practice administrator?
No - we typically work above and alongside practice administration. The fractional executive role adds financial strategy, payer negotiation support, ancillary-line accountability, and partnership-level governance that administrators are rarely positioned to drive, and usually makes the existing management team more effective.
●  FROM THE ARCHIVE  ●

The Orthopedics briefing series

Five sourced, data-driven reports on the business of running an orthopedic practice.

01
Building Ancillary Revenue in Orthopedics: Imaging, PT, and ASC

How orthopedic practices structure in-office imaging, physical therapy, and ASC ownership for durable ancillary revenue – with Stark compliance essentials.

02
Payer Contracting in Orthopedics: Fee Schedules, Bundles, and TEAM

How orthopedic practices negotiate commercial contracts and navigate CMS bundled payment models – BPCI Advanced and the mandatory TEAM model starting 2026.

03
Orthopedic Physician Compensation: wRVUs, Conversion Factors, and What Goes Wrong

wRVU compensation models in orthopedics: 2025 MGMA benchmarks, conversion factor math, and the governance mistakes that drive partner disputes.

04
The PE Offer in Orthopedics: What to Evaluate Before You Sign

Evaluating a PE offer against staying independent: EBITDA multiples, MSO governance, rollover equity risks, and building the independence model first.

05
Block Time and Clinic Flow: The Throughput Problem Most Orthopedic Groups Ignore

Block time and clinic flow in orthopedics: increase surgical revenue without adding physicians by fixing scheduling templates and release protocols.

Book your complimentary discovery call now

Thirty minutes. No pitch. An honest read on where your practice stands.

Free Consultation

(844) 451-0524