Built for orthopedic ASCs

Your denials have a number.
Find it in 60 seconds.

Orthopedic ambulatory surgery centers lose 6–12% of net revenue to insurance denials every year. Most of it is recoverable. Enter your center's parameters — the model runs live and shows you exactly where the money went.

Live estimate · adjust inputs below
$1.1M
Annual revenue leakage
$825K
Estimated recovery
165.0×
ROI multiple
Orthopedic ASC · Industry data
Where your center stands, by the numbers
Published benchmarks from MGMA, HFMA, and the Advisory Board.
10–18%
Initial denial rate, orthopedic ASCs
MGMA DataDive 2023
<60%
Percentage of denials actually appealed
HFMA RCM Workforce Report 2024
55–70%
Appeal win rate, well-managed programs
Advisory Board, ASC Benchmarks 2023
90 days
Time to recover majority of revenue
HFMA 2024
Your center's parameters
Adjust any value — results update instantly on the right.
Case volume & billing
Monthly surgical casescases / month
Average billed charges per case$ / case
Denial & appeal rates
Initial denial rate% of claims denied

Median rangeIndustry median is 10–18%.

Percentage of denials appealed% appealed

Below average

Appeal success rate% of appeals won

Top quartile: 55–70% AI-assisted review typically adds 8–12 percentage points.

Payer mix

Allocate to 100%. Based on your payer mix, expected denial rate is 13.5%.

Medicare
Commercial
Medicaid
Total100%
Annual revenue leakage
$1.1M
Revenue earned, coded, then lost to unappealed or failed denials
Per month
$94K
Total denied value
$1.3M
Estimated recovery
$825K
with structured appeal program
ROI multiple
165.0×
per audit cost
960 cases/yr · $8.2M billed

Your denials tell a clear story.

This is revenue your center earned and coded — then ceded at the back end. A structured appeal program with early denial interception typically recovers the majority within 90 days.

The gap widens every month you wait.

Most orthopedic ASCs appeal fewer than 60% of denials — leaving the rest as permanent write-offs. The arithmetic above assumes you recover only what's realistically recoupable.

Request a free denial audit

Estimates derived from MGMA and HFMA benchmarks. Not a guarantee of results. Your Incerto engagement starts with a free audit on your actual claims data.

Transparent model
How the calculation works
Every number above is derived from four steps. The live values below reflect your current inputs.
1
Gross denied value
Annual billed × denial %
$1.3M
2
Unappealed write-off
Gross denied × (1 − appeal %)
$783K
3
Failed appeal loss
Appealed value × (1 − success %)
$339K
4
Total leakage
Step 2 + Step 3
$1.1M
Recovery model assumptions
8%
Target denial rate
Incerto's automated workflow identifies patterns to reduce initial denials. Best-in-class orthopedic ASCs achieve <8%.
68%
Target appeal success
AI-assisted pre-submission coding review.
Net reimbursement rates by payer
PayerNet rateSource
Commercial38%MGMA 2023
Medicare32%CMS fee schedule avg., ortho ASC
Medicaid24%State-weighted avg., HFMA 2024
Self-pay / Other18%Advisory Board 2023
1 MGMA DataDive Cost and Revenue Report 2023.  2 HFMA Revenue Cycle Workforce Report 2024.  3 Advisory Board, "Denial Rate Benchmarks for ASC Operators," 2023.