What does uhc pay orthopedics groups in CO?
Median published rate is 106% of Medicare across 379 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 182 procedure codes and 1 payer, the median published rate is 167 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare is the only payer with enough confirmed NPIs to publish here, at 167 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 379 confirmed NPIs, and any combination under five is withheld rather than shown thin. These are contracted amounts the payer published, not what a practice was paid, and every row clears the ghost-rate filter, so each NPI counted here actually billed the code in the Medicare utilization file.
Published rates
| Payer | Code | Site | n | p25 | p50 | p75 | % of Medicare |
|---|---|---|---|---|---|---|---|
| UnitedHealthcare | 99213 | professional | 379 | 95.5 | 104.07 | 124.79 | 106% |
| UnitedHealthcare | 99214 | professional | 365 | 141.21 | 154.64 | 200.33 | 110.8% |
| UnitedHealthcare | 99204 | professional | 300 | 220.97 | 239.34 | 291.33 | 131.6% |
| UnitedHealthcare | 99203 | professional | 283 | 138.81 | 149.27 | 178.32 | 123.6% |
| UnitedHealthcare | 20610 | professional | 230 | 90.34 | 97.88 | 115.68 | 140% |
| UnitedHealthcare | 73030 | professional | 133 | 18.62 | 38.59 | 54.37 | 152% |
| UnitedHealthcare | 73502 | professional | 120 | 22.08 | 56.56 | 75.62 | 161.6% |
| UnitedHealthcare | 73564 | professional | 120 | 22.48 | 53.97 | 73.05 | 153.3% |
| UnitedHealthcare | 99212 | professional | 120 | 55.97 | 58.76 | 71.58 | 95.6% |
| UnitedHealthcare | 73562 | professional | 119 | 19.73 | 48.53 | 65.5 | 159.1% |
| UnitedHealthcare | 27447 | professional | 109 | 2271.28 | 2463.94 | 2961.6 | 206.8% |
| UnitedHealthcare | 27130 | professional | 88 | 2264.64 | 2412.12 | 2940.74 | 206.5% |
| UnitedHealthcare | 20550 | professional | 66 | 78.64 | 83.02 | 95.08 | 134.5% |
| UnitedHealthcare | 20600 | professional | 64 | 71.89 | 76.28 | 93 | 132.4% |
| UnitedHealthcare | 99215 | professional | 63 | 202.6 | 212.23 | 264.27 | 107.3% |
| UnitedHealthcare | 73721 | professional | 61 | 245.95 | 384.56 | 579.05 | 235.5% |
| UnitedHealthcare | 20605 | professional | 56 | 75 | 80.31 | 96.38 | 140.6% |
| UnitedHealthcare | 23472 | professional | 54 | 2454.36 | 2686.54 | 3290.24 | 200.1% |
| UnitedHealthcare | 72100 | professional | 54 | 24.8 | 44.67 | 63.73 | 156.2% |
| UnitedHealthcare | 73110 | professional | 51 | 16.47 | 49.12 | 63.73 | 144.2% |
| UnitedHealthcare | 26055 | professional | 46 | 699.54 | 748.06 | 882.85 | 111.5% |
| UnitedHealthcare | 29827 | professional | 45 | 1771.85 | 1915.84 | 2318.25 | 192.8% |
| UnitedHealthcare | 64721 | professional | 45 | 720.12 | 773.08 | 888.79 | 154.1% |
| UnitedHealthcare | 73130 | professional | 44 | 16.41 | 42.69 | 57.3 | 145.8% |
| UnitedHealthcare | 72110 | professional | 43 | 29.7 | 58.47 | 79.51 | 167.1% |
| UnitedHealthcare | 20611 | professional | 42 | 126.63 | 132.84 | 152.11 | 123.4% |
| UnitedHealthcare | 22853 | professional | 41 | 434.69 | 488.5 | 603.71 | 218.4% |
| UnitedHealthcare | 73610 | professional | 40 | 17.78 | 43.71 | 58.56 | 164.3% |
| UnitedHealthcare | 73221 | professional | 39 | 265.88 | 391.31 | 775.46 | 238.4% |
| UnitedHealthcare | 63047 | professional | 38 | 1843.99 | 2078.02 | 2560.98 | 190.7% |
| UnitedHealthcare | 73630 | professional | 38 | 17.21 | 40.49 | 54.78 | 160.7% |
| UnitedHealthcare | 73560 | professional | 35 | 25.31 | 46.45 | 64.83 | 179.4% |
| UnitedHealthcare | 22842 | professional | 33 | 1286.24 | 1440.85 | 1663.19 | 216.9% |
| UnitedHealthcare | 29826 | professional | 33 | 305.13 | 328.05 | 546.77 | 223.9% |
| UnitedHealthcare | 22633 | professional | 30 | 3292.78 | 3501.43 | 4308.7 | 207.1% |
| UnitedHealthcare | 22614 | professional | 28 | 647.69 | 730.94 | 865.61 | 214.3% |
| UnitedHealthcare | 72148 | professional | 26 | 243.69 | 368.79 | 537.29 | 199.7% |
| UnitedHealthcare | 27245 | professional | 25 | 2049.89 | 2306.12 | 2556.47 | 202.4% |
| UnitedHealthcare | 29823 | professional | 24 | 1016.17 | 1122.16 | 1419.66 | 186.9% |
| UnitedHealthcare | 63048 | professional | 23 | 358.58 | 452.81 | 492.13 | 247.3% |
| UnitedHealthcare | 73080 | professional | 23 | 26.36 | 42.92 | 59.55 | 173% |
| UnitedHealthcare | 22612 | professional | 22 | 2657.63 | 2883.64 | 3449.99 | 183.4% |
| UnitedHealthcare | 72040 | professional | 21 | 24.8 | 46.02 | 63.82 | 174.1% |
| UnitedHealthcare | 99205 | professional | 21 | 310.74 | 426.28 | 474.49 | 175.8% |
| UnitedHealthcare | 20526 | professional | 19 | 114.01 | 125.32 | 139.44 | 139.8% |
| UnitedHealthcare | 27236 | professional | 19 | 1931.57 | 2143.41 | 2538.18 | 182% |
| UnitedHealthcare | 29828 | professional | 18 | 1507.65 | 1616.33 | 1829.39 | 180.5% |
| UnitedHealthcare | 63052 | professional | 17 | 493.37 | 525.63 | 611.74 | 234.1% |
| UnitedHealthcare | 22558 | professional | 16 | 2575.19 | 2819.56 | 3163.32 | 182.4% |
| UnitedHealthcare | 22840 | professional | 16 | 1404.28 | 1439.93 | 1772.62 | 220.1% |
| UnitedHealthcare | 27236 | facility | 16 | 3606.75 | 4467 | 6252.5 | 91.5% |
| UnitedHealthcare | 64718 | professional | 16 | 1000.56 | 1057.78 | 1285.51 | 171% |
| UnitedHealthcare | 10005 | facility | 15 | 575.5 | 1006 | 1495 | 258.9% |
| UnitedHealthcare | 10021 | facility | 15 | 227.5 | 598 | 1055 | 942.6% |
| UnitedHealthcare | 11640 | facility | 15 | 575.5 | 1006 | 1495 | 708.5% |
| UnitedHealthcare | 11641 | facility | 15 | 575.5 | 1006 | 1495 | 634.9% |
| UnitedHealthcare | 11642 | facility | 15 | 575.5 | 1006 | 1495 | 583.1% |
| UnitedHealthcare | 11643 | facility | 15 | 575.5 | 1006 | 1495 | 525.8% |
| UnitedHealthcare | 14040 | facility | 15 | 777 | 1329 | 1818 | 117.8% |
| UnitedHealthcare | 14041 | facility | 15 | 777 | 1329 | 1818 | 117.8% |
| UnitedHealthcare | 14060 | facility | 15 | 777 | 1329 | 1818 | 117.8% |
| UnitedHealthcare | 14061 | facility | 15 | 777 | 1329 | 1818 | 117.8% |
| UnitedHealthcare | 15823 | facility | 15 | 777 | 1329 | 1818 | 117.8% |
| UnitedHealthcare | 19296 | facility | 15 | 3809.5 | 4467 | 6453 | 100% |
| UnitedHealthcare | 19298 | facility | 15 | 3809.5 | 4467 | 6453 | 77% |
| UnitedHealthcare | 20526 | facility | 15 | 227.5 | 598 | 1055 | 1149.3% |
| UnitedHealthcare | 20550 | facility | 15 | 227.5 | 598 | 1055 | 1799.6% |
| UnitedHealthcare | 20551 | facility | 15 | 227.5 | 598 | 1055 | 1781.4% |
| UnitedHealthcare | 20552 | facility | 15 | 227.5 | 598 | 1055 | 2120.6% |
| UnitedHealthcare | 20553 | facility | 15 | 227.5 | 598 | 1055 | 1817.6% |
| UnitedHealthcare | 20600 | facility | 15 | 227.5 | 598 | 1055 | 1856% |
| UnitedHealthcare | 20604 | facility | 15 | 227.5 | 598 | 1055 | 1092.8% |
| UnitedHealthcare | 20605 | facility | 15 | 227.5 | 598 | 1055 | 1836.6% |
| UnitedHealthcare | 20606 | facility | 15 | 575.5 | 1006 | 1495 | 1742.3% |
| UnitedHealthcare | 20610 | facility | 15 | 227.5 | 598 | 1055 | 1535.7% |
| UnitedHealthcare | 20611 | facility | 15 | 227.5 | 598 | 1055 | 932.8% |
| UnitedHealthcare | 20680 | facility | 15 | 1469 | 2468 | 2476 | 197.7% |
| UnitedHealthcare | 21315 | facility | 15 | 777 | 1329 | 1818 | 201.6% |
| UnitedHealthcare | 21320 | facility | 15 | 777 | 1329 | 1818 | 89.8% |
| UnitedHealthcare | 21555 | facility | 15 | 777 | 1329 | 1818 | 179.1% |
| UnitedHealthcare | 22510 | facility | 15 | 2261 | 3825 | 6359.5 | 232.5% |
| UnitedHealthcare | 22511 | facility | 15 | 2261 | 3825 | 6359.5 | 232.5% |
| UnitedHealthcare | 22513 | facility | 15 | 3809.5 | 6359.5 | 6606.75 | 172.1% |
| UnitedHealthcare | 22514 | facility | 15 | 3809.5 | 6359.5 | 7363.5 | 172.1% |
| UnitedHealthcare | 22551 | facility | 15 | 8122 | 13291.5 | 15586.5 | 147.2% |
| UnitedHealthcare | 22558 | facility | 15 | 5961.5 | 10453 | 21075.5 | 52% |
| UnitedHealthcare | 22600 | facility | 15 | 5961.5 | 10453 | 12726.5 | 79.8% |
| UnitedHealthcare | 22612 | facility | 15 | 4293 | 4467 | 12939.5 | 33.1% |
| UnitedHealthcare | 22630 | facility | 15 | 5921 | 10453 | 17493 | 50.1% |
| UnitedHealthcare | 22633 | facility | 15 | 10255.25 | 12740.5 | 20889.5 | 61.1% |
| UnitedHealthcare | 22800 | facility | 15 | 5921 | 10041 | 10453 | 74.4% |
| UnitedHealthcare | 22802 | facility | 15 | 5921 | 10041 | 10453 | 72.1% |
| UnitedHealthcare | 22804 | facility | 15 | 5921 | 10041 | 10453 | 72.1% |
| UnitedHealthcare | 22810 | facility | 15 | 5921 | 10041 | 10453 | 72.1% |
| UnitedHealthcare | 22812 | facility | 15 | 5921 | 10041 | 10453 | 72.1% |
| UnitedHealthcare | 22849 | facility | 15 | 5921 | 10041 | 10453 | 109% |
| UnitedHealthcare | 22850 | facility | 15 | 3809.5 | 6854 | 8733 | 185.5% |
| UnitedHealthcare | 22852 | facility | 15 | 3809.5 | 6854 | 8733 | 185.5% |
| UnitedHealthcare | 22855 | facility | 15 | 3809.5 | 6854 | 8733 | 185.5% |
| UnitedHealthcare | 22856 | facility | 15 | 8002 | 11885 | 18813.5 | 90.7% |
| UnitedHealthcare | 22861 | facility | 15 | 5921 | 10189 | 10453 | 87.1% |
| UnitedHealthcare | 23472 | facility | 15 | 9236.5 | 21834 | 25507.5 | 156.9% |
| UnitedHealthcare | 24500 | facility | 15 | 227.5 | 598 | 1055 | 441.2% |
| UnitedHealthcare | 24505 | facility | 15 | 227.5 | 598 | 1055 | 68.5% |
| UnitedHealthcare | 25600 | facility | 15 | 227.5 | 598 | 1055 | 441.2% |
| UnitedHealthcare | 25605 | facility | 15 | 575.5 | 1006 | 1495 | 115.3% |
| UnitedHealthcare | 25607 | facility | 15 | 3809.5 | 6613.5 | 6733.75 | 133% |
| UnitedHealthcare | 25608 | facility | 15 | 3809.5 | 6613.5 | 6733.75 | 132.8% |
| UnitedHealthcare | 25609 | facility | 15 | 3809.5 | 6613.5 | 6733.75 | 131.9% |
| UnitedHealthcare | 26055 | facility | 15 | 777 | 1329 | 1818 | 152.3% |
| UnitedHealthcare | 26160 | facility | 15 | 777 | 1329 | 1818 | 152.3% |
| UnitedHealthcare | 26600 | facility | 15 | 227.5 | 598 | 1055 | 441.2% |
| UnitedHealthcare | 27130 | facility | 15 | 10486.5 | 22316 | 25507.5 | 232.1% |
| UnitedHealthcare | 27134 | facility | 15 | 10486.5 | 21043.5 | 25507.5 | 225.6% |
| UnitedHealthcare | 27245 | facility | 15 | 2782.5 | 3239 | 4972 | 67% |
| UnitedHealthcare | 27278 | facility | 15 | 5921 | 10041 | 10453 | 66.7% |
| UnitedHealthcare | 27279 | facility | 15 | 5961.5 | 10453 | 14226.5 | 72% |
| UnitedHealthcare | 27280 | facility | 15 | 5921 | 10453 | 15194.5 | 75.7% |
| UnitedHealthcare | 27446 | facility | 15 | 5961.5 | 18624 | 25507.5 | 202.1% |
| UnitedHealthcare | 27447 | facility | 15 | 10236.5 | 22798 | 25507.5 | 242.7% |
| UnitedHealthcare | 27486 | facility | 15 | 5961.5 | 19936 | 25507.5 | 293% |
| UnitedHealthcare | 27487 | facility | 15 | 5961.5 | 21043.5 | 25507.5 | 150.7% |
| UnitedHealthcare | 27750 | facility | 15 | 227.5 | 598 | 1055 | 441.2% |
| UnitedHealthcare | 27752 | facility | 15 | 777 | 1329 | 1818 | 152.3% |
| UnitedHealthcare | 27786 | facility | 15 | 227.5 | 598 | 1055 | 441.2% |
| UnitedHealthcare | 27808 | facility | 15 | 227.5 | 598 | 1055 | 441.2% |
| UnitedHealthcare | 27816 | facility | 15 | 227.5 | 598 | 1055 | 441.2% |
| UnitedHealthcare | 28470 | facility | 15 | 227.5 | 598 | 1055 | 441.2% |
| UnitedHealthcare | 29515 | facility | 15 | 227.5 | 598 | 1055 | 1079.6% |
| UnitedHealthcare | 29540 | facility | 15 | 227.5 | 598 | 1055 | 4144.1% |
| UnitedHealthcare | 29580 | facility | 15 | 227.5 | 598 | 1055 | 1391.7% |
| UnitedHealthcare | 29805 | facility | 15 | 2261 | 3227 | 3504.5 | 196.2% |
| UnitedHealthcare | 29806 | facility | 15 | 3953 | 5146 | 6453 | 139.2% |
| UnitedHealthcare | 29807 | facility | 15 | 3953 | 5146 | 6453 | 139.2% |
| UnitedHealthcare | 29819 | facility | 15 | 3953 | 5146 | 6453 | 312.9% |
| UnitedHealthcare | 29820 | facility | 15 | 3953 | 5146 | 7248 | 139.2% |
| UnitedHealthcare | 29821 | facility | 15 | 3953 | 5146 | 6453 | 312.9% |
| UnitedHealthcare | 29822 | facility | 15 | 2261 | 3769 | 5146 | 229.1% |
| UnitedHealthcare | 29823 | facility | 15 | 3953 | 5146 | 6453 | 312.9% |
| UnitedHealthcare | 29824 | facility | 15 | 3953 | 5146 | 6453 | 312.9% |
| UnitedHealthcare | 29825 | facility | 15 | 3953 | 5146 | 6453 | 312.9% |
| UnitedHealthcare | 29827 | facility | 15 | 3953 | 5146 | 6453 | 139.2% |
| UnitedHealthcare | 29828 | facility | 15 | 3953 | 5146 | 6453 | 139.2% |
| UnitedHealthcare | 29870 | facility | 15 | 2261 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29873 | facility | 15 | 2261 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29874 | facility | 15 | 2261 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29875 | facility | 15 | 2261 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29876 | facility | 15 | 2261 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29877 | facility | 15 | 2304.5 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29879 | facility | 15 | 2304.5 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29880 | facility | 15 | 2304.5 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29881 | facility | 15 | 2304.5 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29882 | facility | 15 | 2304.5 | 3755 | 3762 | 228.3% |
| UnitedHealthcare | 29888 | facility | 15 | 4024 | 6775.5 | 6904.75 | 140.7% |
| UnitedHealthcare | 29889 | facility | 15 | 4024 | 6775.5 | 6904.75 | 68.2% |
| UnitedHealthcare | 29891 | facility | 15 | 3809.5 | 4467 | 6453 | 271.6% |
| UnitedHealthcare | 29894 | facility | 15 | 2261 | 3227 | 3498 | 196.2% |
| UnitedHealthcare | 29895 | facility | 15 | 2261 | 3227 | 3498 | 196.2% |
| UnitedHealthcare | 29914 | facility | 15 | 4024 | 5246.5 | 6154 | 142% |
| UnitedHealthcare | 29915 | facility | 15 | 4024 | 5246.5 | 6154 | 142% |
| UnitedHealthcare | 29916 | facility | 15 | 4024 | 5246.5 | 6154 | 142% |
| UnitedHealthcare | 30115 | facility | 15 | 1469 | 2468 | 2476 | 166.7% |
| UnitedHealthcare | 30130 | facility | 15 | 1469 | 2468 | 2476 | 166.7% |
| UnitedHealthcare | 30140 | facility | 15 | 1469 | 2468 | 2476 | 166.7% |
| UnitedHealthcare | 30420 | facility | 15 | 2782.5 | 3239 | 4972 | 107.1% |
| UnitedHealthcare | 30450 | facility | 15 | 2782.5 | 3239 | 4972 | 107.1% |
| UnitedHealthcare | 30465 | facility | 15 | 2782.5 | 3239 | 4972 | 107.1% |
| UnitedHealthcare | 30468 | facility | 15 | 2782.5 | 3239 | 4972 | 77.4% |
| UnitedHealthcare | 30469 | facility | 15 | 2782.5 | 3239 | 4972 | 80.1% |
| UnitedHealthcare | 30520 | facility | 15 | 1469 | 2484 | 3373.5 | 167.8% |
| UnitedHealthcare | 30801 | facility | 15 | 777 | 1329 | 1818 | 201.6% |
| UnitedHealthcare | 30802 | facility | 15 | 777 | 1329 | 1818 | 201.6% |
| UnitedHealthcare | 30903 | facility | 15 | 227.5 | 598 | 1055 | 813.2% |
| UnitedHealthcare | 30905 | facility | 15 | 227.5 | 598 | 1055 | 813.2% |
| UnitedHealthcare | 30906 | facility | 15 | 227.5 | 598 | 1055 | 461.8% |
| UnitedHealthcare | 31231 | facility | 15 | 227.5 | 598 | 1055 | 545% |
| UnitedHealthcare | 31237 | facility | 15 | 777 | 1329 | 3373.5 | 157.5% |
| UnitedHealthcare | 31238 | facility | 15 | 777 | 1329 | 3373.5 | 157.5% |
| UnitedHealthcare | 31239 | facility | 15 | 1519.5 | 2520.5 | 3373.5 | 148.6% |
| UnitedHealthcare | 31240 | facility | 15 | 1519.5 | 2520.5 | 3373.5 | 298.7% |
| UnitedHealthcare | 31253 | facility | 15 | 2261 | 3373.5 | 3571.25 | 137.6% |
| UnitedHealthcare | 31254 | facility | 15 | 1519.5 | 2520.5 | 3373.5 | 102.8% |
| UnitedHealthcare | 31255 | facility | 15 | 2261 | 3373.5 | 3571.25 | 137.6% |
| UnitedHealthcare | 31256 | facility | 15 | 1519.5 | 2520.5 | 3373.5 | 148.6% |
| UnitedHealthcare | 31257 | facility | 15 | 2261 | 3373.5 | 3797 | 137.6% |
| UnitedHealthcare | 31259 | facility | 15 | 2261 | 3373.5 | 3797 | 137.6% |
| UnitedHealthcare | 31267 | facility | 15 | 1519.5 | 2520.5 | 3373.5 | 102.8% |
| UnitedHealthcare | 31276 | facility | 15 | 2261 | 3373.5 | 3743.5 | 137.6% |
| UnitedHealthcare | 31287 | facility | 15 | 2261 | 3373.5 | 3743.5 | 137.6% |
| UnitedHealthcare | 31288 | facility | 15 | 2261 | 3373.5 | 3743.5 | 137.6% |
| UnitedHealthcare | 31295 | facility | 15 | 2261 | 3373.5 | 3571.25 | 108.6% |
| UnitedHealthcare | 31296 | facility | 15 | 2261 | 3373.5 | 3571.25 | 225.4% |
| UnitedHealthcare | 31297 | facility | 15 | 1519.5 | 3327 | 3373.5 | 106.9% |
| UnitedHealthcare | 31298 | facility | 15 | 2261 | 3227 | 3548 | 131.7% |
| UnitedHealthcare | 31535 | facility | 15 | 1469 | 2468 | 2476 | 145.5% |
| UnitedHealthcare | 31536 | facility | 15 | 1469 | 2468 | 2476 | 145.5% |
| UnitedHealthcare | 31540 | facility | 15 | 1469 | 2468 | 2476 | 145.5% |
| UnitedHealthcare | 31541 | facility | 15 | 1469 | 2468 | 2476 | 145.5% |
| UnitedHealthcare | 31575 | facility | 15 | 227.5 | 598 | 1055 | 645.4% |
| UnitedHealthcare | 31576 | facility | 15 | 777 | 1329 | 1818 | 157.5% |
ASC versus hospital savings appears only when a hospital outpatient rate is published. Hospital OPPS is not in this phase.
Median rate by payer, percent of Medicare
Solid line 100% of Medicare.
How this is measured
Rates come from each payer's published Transparency in Coverage machine-readable file, filtered to this specialty's codes and to NPIs the CMS Medicare utilization file shows billing that code. Percentiles are computed per payer, code and site of service across those NPIs, then divided by the locality-adjusted Medicare amount for the same code and place. Full methodology.
- Payer files: 2026-09
Questions
Is this what the practice was paid?
No. These are contracted rates as published by the payer, not allowed or paid amounts.
Why are some cells blank?
Ghost rates are removed using Medicare utilization. A row appears only if that NPI billed the code.
What is an episode total?
Professional plus facility when both exist. We never average them or invent a total from one side.
Saran Siva
Co-founder & CTO, Insight Health · September 2026 files