What does uhc pay orthopedics groups in TN?
Median published rate is 112.4% of Medicare across 482 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 174 procedure codes and 1 payer, the median published rate is 156 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare is the only payer with enough confirmed NPIs to publish here, at 156 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 482 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 | 482 | 81.48 | 100.42 | 147.15 | 112.4% |
| UnitedHealthcare | 99214 | professional | 456 | 128.07 | 149.64 | 210.94 | 117.6% |
| UnitedHealthcare | 99204 | professional | 379 | 206.89 | 236.3 | 343.07 | 142.2% |
| UnitedHealthcare | 20610 | professional | 345 | 83.01 | 100.29 | 139.04 | 158.6% |
| UnitedHealthcare | 99203 | professional | 326 | 128.92 | 150.23 | 201.23 | 136.9% |
| UnitedHealthcare | 73030 | professional | 250 | 18.23 | 28.58 | 40.32 | 135.8% |
| UnitedHealthcare | 73502 | professional | 248 | 21.93 | 41.14 | 56.48 | 137.7% |
| UnitedHealthcare | 73562 | professional | 202 | 18.28 | 35.84 | 48.23 | 132.9% |
| UnitedHealthcare | 27447 | professional | 178 | 2264.11 | 2520.05 | 3109.1 | 237.3% |
| UnitedHealthcare | 72100 | professional | 156 | 21.88 | 35.62 | 52.7 | 142.1% |
| UnitedHealthcare | 73564 | professional | 156 | 20.46 | 39.68 | 54.44 | 133.6% |
| UnitedHealthcare | 99212 | professional | 144 | 48.41 | 59.13 | 70.85 | 106.7% |
| UnitedHealthcare | 73721 | professional | 132 | 151.24 | 254.86 | 339.81 | 251.1% |
| UnitedHealthcare | 27130 | professional | 122 | 2132.97 | 2522.68 | 2908.48 | 237.1% |
| UnitedHealthcare | 73130 | professional | 112 | 18.09 | 31.62 | 42.61 | 134.6% |
| UnitedHealthcare | 73560 | professional | 107 | 17.23 | 29.31 | 40.49 | 139.7% |
| UnitedHealthcare | 20550 | professional | 102 | 83.39 | 88.69 | 117.24 | 160.6% |
| UnitedHealthcare | 73221 | professional | 97 | 152.81 | 276.99 | 362.22 | 252.5% |
| UnitedHealthcare | 73610 | professional | 97 | 17.42 | 31.62 | 42.44 | 135.6% |
| UnitedHealthcare | 73110 | professional | 94 | 18.79 | 36.7 | 53.08 | 136.1% |
| UnitedHealthcare | 99215 | professional | 92 | 167.12 | 195.85 | 230.91 | 108.4% |
| UnitedHealthcare | 72148 | professional | 91 | 165.73 | 263.07 | 344.01 | 252.5% |
| UnitedHealthcare | 20605 | professional | 80 | 78.6 | 85.54 | 123.74 | 167.7% |
| UnitedHealthcare | 72040 | professional | 80 | 23.46 | 35.2 | 51.93 | 154.2% |
| UnitedHealthcare | 73630 | professional | 79 | 17.42 | 29.95 | 41.13 | 144.5% |
| UnitedHealthcare | 20600 | professional | 66 | 74.1 | 81.25 | 105.52 | 157% |
| UnitedHealthcare | 23472 | professional | 63 | 2248.97 | 2705.17 | 3989.34 | 226.7% |
| UnitedHealthcare | 64721 | professional | 62 | 718.94 | 799.07 | 1178.4 | 180.7% |
| UnitedHealthcare | 26055 | professional | 54 | 736.32 | 857.99 | 1128.82 | 149.4% |
| UnitedHealthcare | 27245 | professional | 52 | 1940.83 | 2207.08 | 2381.14 | 213.2% |
| UnitedHealthcare | 20611 | professional | 50 | 119.87 | 140.86 | 144.17 | 146.4% |
| UnitedHealthcare | 29826 | professional | 49 | 276.59 | 326.2 | 481.05 | 240% |
| UnitedHealthcare | 29827 | professional | 47 | 1693.8 | 1990.38 | 2306.1 | 222.2% |
| UnitedHealthcare | 72110 | professional | 44 | 28.03 | 48.23 | 69.88 | 159.4% |
| UnitedHealthcare | 73552 | professional | 43 | 15.25 | 31.98 | 42.98 | 140% |
| UnitedHealthcare | 96372 | professional | 42 | 24.42 | 26.8 | 38.61 | 186.7% |
| UnitedHealthcare | 97110 | professional | 42 | 40.31 | 43.55 | 53.28 | 157.5% |
| UnitedHealthcare | 99205 | professional | 40 | 204.17 | 270.98 | 435.82 | 122.4% |
| UnitedHealthcare | 22853 | professional | 37 | 415.48 | 509.18 | 698.21 | 249.6% |
| UnitedHealthcare | 27236 | professional | 36 | 1543.64 | 2205.72 | 2208.74 | 220.8% |
| UnitedHealthcare | 63047 | professional | 36 | 1702.04 | 2116.63 | 2963.56 | 217.9% |
| UnitedHealthcare | 73080 | professional | 36 | 18.79 | 32.8 | 43.67 | 151% |
| UnitedHealthcare | 97140 | professional | 35 | 38.82 | 50.42 | 50.42 | 191.1% |
| UnitedHealthcare | 97530 | professional | 35 | 46.76 | 47.42 | 55.9 | 143.3% |
| UnitedHealthcare | 22842 | professional | 30 | 1348.63 | 1594.59 | 2061.9 | 263.3% |
| UnitedHealthcare | 29823 | professional | 30 | 814.2 | 1156.2 | 1617.83 | 222% |
| UnitedHealthcare | 20526 | professional | 29 | 110.45 | 126.02 | 153.81 | 155.9% |
| UnitedHealthcare | 72141 | professional | 28 | 165.73 | 263.63 | 323.26 | 253.7% |
| UnitedHealthcare | 97112 | professional | 28 | 44.97 | 55.98 | 55.98 | 179.7% |
| UnitedHealthcare | 22612 | professional | 27 | 2380.86 | 2888.27 | 3269.52 | 214.9% |
| UnitedHealthcare | 29824 | professional | 26 | 851.39 | 1160.55 | 1522.42 | 192.1% |
| UnitedHealthcare | 73501 | professional | 26 | 17.4 | 26.85 | 40.51 | 137.5% |
| UnitedHealthcare | 22840 | professional | 24 | 1222.85 | 1542.61 | 2054.13 | 258% |
| UnitedHealthcare | 22614 | professional | 21 | 716.9 | 817.18 | 1057.22 | 262.9% |
| UnitedHealthcare | 22633 | professional | 21 | 2867.44 | 3707.4 | 4993.7 | 244% |
| UnitedHealthcare | 72070 | professional | 21 | 20.85 | 29.51 | 44.11 | 159.3% |
| UnitedHealthcare | 29881 | professional | 20 | 812.73 | 1002.38 | 1478.23 | 208.1% |
| UnitedHealthcare | 20551 | professional | 18 | 84.99 | 88.37 | 128.19 | 160.4% |
| UnitedHealthcare | 22558 | professional | 17 | 2393.95 | 2795.85 | 3247.82 | 213.3% |
| UnitedHealthcare | 61783 | professional | 16 | 358.79 | 404.71 | 487.82 | 220.7% |
| UnitedHealthcare | 27446 | professional | 15 | 1922.36 | 2155.02 | 2261.58 | 224.7% |
| UnitedHealthcare | 27487 | professional | 15 | 2785.31 | 3684.68 | 4829.2 | 255.5% |
| UnitedHealthcare | 63048 | professional | 15 | 336.45 | 426.15 | 569.64 | 255.3% |
| UnitedHealthcare | 64718 | professional | 15 | 947.92 | 1100 | 1445.94 | 208.9% |
| UnitedHealthcare | 29828 | professional | 14 | 1155.6 | 1600.48 | 2396.96 | 172.6% |
| UnitedHealthcare | 63052 | professional | 14 | 402.81 | 515.97 | 705.51 | 252.1% |
| UnitedHealthcare | 20605 | facility | 13 | 134 | 190 | 550 | 583.5% |
| UnitedHealthcare | 26160 | professional | 13 | 812.82 | 812.82 | 853.85 | 135.4% |
| UnitedHealthcare | 73565 | professional | 13 | 14.45 | 34.25 | 45.08 | 119.3% |
| UnitedHealthcare | 20550 | facility | 12 | 158 | 277.25 | 566 | 834.4% |
| UnitedHealthcare | 20552 | professional | 12 | 52.78 | 84.25 | 91.57 | 182.8% |
| UnitedHealthcare | 22551 | professional | 12 | 2519.74 | 3226.07 | 3476 | 205.7% |
| UnitedHealthcare | 22845 | professional | 12 | 1133.42 | 1298.54 | 1516.51 | 225.4% |
| UnitedHealthcare | 27130 | facility | 12 | 6841.5 | 15372.5 | 19649 | 177.8% |
| UnitedHealthcare | 29515 | facility | 12 | 158 | 277.25 | 566 | 500.6% |
| UnitedHealthcare | 10005 | facility | 11 | 569.5 | 803 | 956.5 | 206.7% |
| UnitedHealthcare | 10021 | facility | 11 | 169.5 | 364.5 | 582 | 574.6% |
| UnitedHealthcare | 11640 | facility | 11 | 569.5 | 803 | 956.5 | 565.5% |
| UnitedHealthcare | 11641 | facility | 11 | 569.5 | 803 | 956.5 | 506.8% |
| UnitedHealthcare | 11642 | facility | 11 | 569.5 | 803 | 956.5 | 465.4% |
| UnitedHealthcare | 11643 | facility | 11 | 569.5 | 803 | 956.5 | 419.7% |
| UnitedHealthcare | 14040 | facility | 11 | 861.5 | 932 | 1438 | 82.6% |
| UnitedHealthcare | 14041 | facility | 11 | 861.5 | 932 | 1438 | 82.6% |
| UnitedHealthcare | 14060 | facility | 11 | 861.5 | 932 | 1438 | 82.6% |
| UnitedHealthcare | 14061 | facility | 11 | 861.5 | 932 | 1438 | 82.6% |
| UnitedHealthcare | 15823 | facility | 11 | 861.5 | 932 | 1438 | 82.6% |
| UnitedHealthcare | 19296 | facility | 11 | 3779 | 4101 | 5551.5 | 91.8% |
| UnitedHealthcare | 19298 | facility | 11 | 3779 | 4101 | 5551.5 | 70.7% |
| UnitedHealthcare | 20526 | facility | 11 | 169.5 | 364.5 | 582 | 700.6% |
| UnitedHealthcare | 20551 | facility | 11 | 169.5 | 364.5 | 582 | 1085.8% |
| UnitedHealthcare | 20552 | facility | 11 | 169.5 | 364.5 | 582 | 1292.6% |
| UnitedHealthcare | 20553 | facility | 11 | 169.5 | 364.5 | 582 | 1107.9% |
| UnitedHealthcare | 20600 | facility | 11 | 169.5 | 364.5 | 582 | 1131.3% |
| UnitedHealthcare | 20604 | facility | 11 | 169.5 | 364.5 | 582 | 666.1% |
| UnitedHealthcare | 20606 | facility | 11 | 569.5 | 803 | 956.5 | 1390.7% |
| UnitedHealthcare | 20610 | facility | 11 | 169.5 | 364.5 | 582 | 936.1% |
| UnitedHealthcare | 20611 | facility | 11 | 169.5 | 364.5 | 582 | 568.6% |
| UnitedHealthcare | 20680 | facility | 11 | 1599 | 1842 | 2025 | 147.6% |
| UnitedHealthcare | 21315 | facility | 11 | 861.5 | 932 | 1438 | 141.4% |
| UnitedHealthcare | 21320 | facility | 11 | 861.5 | 932 | 1438 | 63% |
| UnitedHealthcare | 21555 | facility | 11 | 861.5 | 932 | 1438 | 125.6% |
| UnitedHealthcare | 22510 | facility | 11 | 1875 | 2590 | 3916.5 | 157.5% |
| UnitedHealthcare | 22511 | facility | 11 | 1875 | 2590 | 3916.5 | 157.5% |
| UnitedHealthcare | 22513 | facility | 11 | 3951 | 4200 | 5551.5 | 113.7% |
| UnitedHealthcare | 22514 | facility | 11 | 3951 | 4200 | 5551.5 | 113.7% |
| UnitedHealthcare | 22551 | facility | 11 | 9114.5 | 12000 | 14041 | 132.9% |
| UnitedHealthcare | 22558 | facility | 11 | 4136.5 | 8385 | 12242 | 41.7% |
| UnitedHealthcare | 22600 | facility | 11 | 4136.5 | 8385 | 10293.25 | 64% |
| UnitedHealthcare | 22612 | facility | 11 | 3779 | 4600 | 10941.5 | 34.1% |
| UnitedHealthcare | 22630 | facility | 11 | 4136.5 | 8385 | 11124.75 | 40.2% |
| UnitedHealthcare | 22633 | facility | 11 | 5785.5 | 9618 | 12851 | 46.1% |
| UnitedHealthcare | 22800 | facility | 11 | 4136.5 | 8385 | 10293.25 | 62.2% |
| UnitedHealthcare | 22802 | facility | 11 | 4136.5 | 8385 | 10293.25 | 60.2% |
| UnitedHealthcare | 22804 | facility | 11 | 4136.5 | 8385 | 10293.25 | 60.2% |
| UnitedHealthcare | 22810 | facility | 11 | 4136.5 | 8385 | 10293.25 | 60.2% |
| UnitedHealthcare | 22812 | facility | 11 | 4136.5 | 8385 | 10293.25 | 60.2% |
| UnitedHealthcare | 22849 | facility | 11 | 4136.5 | 8385 | 10293.25 | 91% |
| UnitedHealthcare | 22850 | facility | 11 | 3951 | 4600 | 6538.5 | 124.5% |
| UnitedHealthcare | 22852 | facility | 11 | 3951 | 4600 | 6538.5 | 124.5% |
| UnitedHealthcare | 22855 | facility | 11 | 3951 | 4600 | 6538.5 | 124.5% |
| UnitedHealthcare | 22856 | facility | 11 | 3951 | 6020 | 11274.75 | 46% |
| UnitedHealthcare | 22861 | facility | 11 | 4136.5 | 8385 | 10293.25 | 71.7% |
| UnitedHealthcare | 23472 | facility | 11 | 9781 | 16179 | 20509.5 | 116.3% |
| UnitedHealthcare | 24500 | facility | 11 | 169.5 | 364.5 | 582 | 268.9% |
| UnitedHealthcare | 24505 | facility | 11 | 169.5 | 364.5 | 582 | 41.8% |
| UnitedHealthcare | 25600 | facility | 11 | 169.5 | 364.5 | 582 | 268.9% |
| UnitedHealthcare | 25605 | facility | 11 | 569.5 | 803 | 956.5 | 92% |
| UnitedHealthcare | 25607 | facility | 11 | 3951 | 4200 | 5551.5 | 84.5% |
| UnitedHealthcare | 25608 | facility | 11 | 3951 | 4200 | 5551.5 | 84.3% |
| UnitedHealthcare | 25609 | facility | 11 | 3951 | 4200 | 5551.5 | 83.8% |
| UnitedHealthcare | 26055 | facility | 11 | 861.5 | 932 | 1438 | 106.8% |
| UnitedHealthcare | 26160 | facility | 11 | 861.5 | 932 | 1438 | 106.8% |
| UnitedHealthcare | 26600 | facility | 11 | 169.5 | 364.5 | 582 | 268.9% |
| UnitedHealthcare | 27134 | facility | 11 | 9781 | 16179 | 20473 | 173.5% |
| UnitedHealthcare | 27236 | facility | 11 | 3779 | 4101 | 5551.5 | 84% |
| UnitedHealthcare | 27245 | facility | 11 | 2576.5 | 3206 | 4349.5 | 66.4% |
| UnitedHealthcare | 27278 | facility | 11 | 4136.5 | 8385 | 10293.25 | 55.7% |
| UnitedHealthcare | 27279 | facility | 11 | 4136.5 | 8385 | 10293.25 | 57.8% |
| UnitedHealthcare | 27280 | facility | 11 | 4136.5 | 8385 | 11124.75 | 60.7% |
| UnitedHealthcare | 27446 | facility | 11 | 9781 | 16179 | 18857 | 175.6% |
| UnitedHealthcare | 27447 | facility | 11 | 9781 | 16179 | 21005.5 | 172.2% |
| UnitedHealthcare | 27486 | facility | 11 | 4136.5 | 8436 | 20445.5 | 124% |
| UnitedHealthcare | 27487 | facility | 11 | 4136.5 | 8436 | 20445.5 | 60.4% |
| UnitedHealthcare | 27750 | facility | 11 | 169.5 | 364.5 | 582 | 268.9% |
| UnitedHealthcare | 27752 | facility | 11 | 861.5 | 932 | 1438 | 106.8% |
| UnitedHealthcare | 27786 | facility | 11 | 169.5 | 364.5 | 582 | 268.9% |
| UnitedHealthcare | 27808 | facility | 11 | 169.5 | 364.5 | 582 | 268.9% |
| UnitedHealthcare | 27816 | facility | 11 | 169.5 | 364.5 | 582 | 268.9% |
| UnitedHealthcare | 28470 | facility | 11 | 169.5 | 364.5 | 582 | 268.9% |
| UnitedHealthcare | 29540 | facility | 11 | 169.5 | 364.5 | 582 | 2526% |
| UnitedHealthcare | 29580 | facility | 11 | 169.5 | 364.5 | 582 | 848.3% |
| UnitedHealthcare | 29805 | facility | 11 | 1875 | 2545 | 3279 | 154.7% |
| UnitedHealthcare | 29806 | facility | 11 | 3851 | 4540 | 5551.5 | 122.9% |
| UnitedHealthcare | 29807 | facility | 11 | 3851 | 4540 | 5551.5 | 122.9% |
| UnitedHealthcare | 29819 | facility | 11 | 3851 | 4540 | 5551.5 | 276% |
| UnitedHealthcare | 29820 | facility | 11 | 3851 | 4540 | 5551.5 | 122.9% |
| UnitedHealthcare | 29821 | facility | 11 | 3851 | 4540 | 5551.5 | 276% |
| UnitedHealthcare | 29822 | facility | 11 | 1875 | 2590 | 3840.5 | 157.5% |
| UnitedHealthcare | 29823 | facility | 11 | 3851 | 4540 | 5551.5 | 276% |
| UnitedHealthcare | 29824 | facility | 11 | 3851 | 4147 | 4841.5 | 252.1% |
| UnitedHealthcare | 29825 | facility | 11 | 3851 | 4540 | 5551.5 | 276% |
| UnitedHealthcare | 29827 | facility | 11 | 3851 | 4540 | 5551.5 | 122.9% |
| UnitedHealthcare | 29828 | facility | 11 | 3851 | 4540 | 5551.5 | 122.9% |
| UnitedHealthcare | 29870 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29873 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29874 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29875 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29876 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29877 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29879 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29880 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29881 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29882 | facility | 11 | 1875 | 2626 | 3618.25 | 159.6% |
| UnitedHealthcare | 29888 | facility | 11 | 3906 | 4556 | 5760 | 94.6% |
| UnitedHealthcare | 29889 | facility | 11 | 3906 | 4556 | 5760 | 45.9% |
| UnitedHealthcare | 29891 | facility | 11 | 3779 | 4101 | 5551.5 | 249.3% |
| UnitedHealthcare | 29894 | facility | 11 | 1875 | 2545 | 3279 | 154.7% |
| UnitedHealthcare | 29895 | facility | 11 | 1875 | 2545 | 3279 | 154.7% |
| UnitedHealthcare | 29914 | facility | 11 | 3903.25 | 4101 | 5551.5 | 111% |
| UnitedHealthcare | 29915 | facility | 11 | 3903.25 | 4101 | 5551.5 | 111% |
| UnitedHealthcare | 29916 | facility | 11 | 3903.25 | 4101 | 5551.5 | 111% |
| UnitedHealthcare | 30115 | facility | 11 | 1599 | 1842 | 2025 | 124.4% |
| UnitedHealthcare | 30130 | facility | 11 | 1599 | 1842 | 2025 | 124.4% |
| UnitedHealthcare | 30140 | facility | 11 | 1599 | 1842 | 2025 | 124.4% |
| UnitedHealthcare | 30420 | facility | 11 | 2576.5 | 3206 | 4349.5 | 106% |
| UnitedHealthcare | 30450 | facility | 11 | 2576.5 | 3206 | 4349.5 | 106% |
| UnitedHealthcare | 30465 | facility | 11 | 2576.5 | 3206 | 4349.5 | 106% |
| UnitedHealthcare | 30468 | facility | 11 | 2576.5 | 3206 | 4349.5 | 76.6% |
| UnitedHealthcare | 30469 | facility | 11 | 2576.5 | 3206 | 4349.5 | 79.3% |
| UnitedHealthcare | 30520 | facility | 11 | 1599 | 1845 | 2605.25 | 124.6% |
| UnitedHealthcare | 30801 | facility | 11 | 861.5 | 932 | 1438 | 141.4% |
| UnitedHealthcare | 30802 | facility | 11 | 861.5 | 932 | 1438 | 141.4% |
| UnitedHealthcare | 30903 | facility | 11 | 169.5 | 364.5 | 582 | 495.6% |
| UnitedHealthcare | 30905 | facility | 11 | 169.5 | 364.5 | 582 | 495.6% |
| UnitedHealthcare | 30906 | facility | 11 | 169.5 | 364.5 | 582 | 281.5% |
| UnitedHealthcare | 31231 | facility | 11 | 169.5 | 364.5 | 582 | 332.2% |
| UnitedHealthcare | 31237 | facility | 11 | 861.5 | 1200 | 1592 | 142.2% |
| UnitedHealthcare | 31238 | facility | 11 | 861.5 | 1200 | 1528 | 142.2% |
| UnitedHealthcare | 31239 | facility | 11 | 1599 | 1845 | 2356.5 | 108.8% |
| UnitedHealthcare | 31240 | facility | 11 | 1599 | 1845 | 2605.25 | 218.7% |
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