Specialty RCM Orthopedic Surgery & ASC Facility Las Vegas, NV (14 Surgeons)
Pinnacle Orthopedics ASC: Dual Physician & Ambulatory Surgery Center RCM Success
Dual-billing professional surgeon fees and ASC facility claims for major joint replacements.
Published February 2026 6 min read
+27%
ASC Facility Yield
Facility fee reimbursement lift
22 Days
Days in A/R
Combined professional & ASC A/R
99.2%
Clean Claim Rate
First-pass clean rate
The Challenge
- Discrepancies between surgeon professional CPT codes and ASC facility UB-04 revenue codes.
- High implant supply costs written off due to un-attached invoice documentation.
- Delayed ASC facility reimbursement from commercial managed care payers.
The Solution & Strategy
- Synchronized professional CMS-1500 and facility UB-04 claim generation within a single RCM workflow.
- Automated digital attachment of manufacturer implant invoices to high-dollar surgical claims.
- Established direct payer portal integrations for rapid electronic ASC claim tracking.
Quantifiable Key Results
ASC Facility Yield
+27%
Eliminated implant write-offsDays in A/R
22 Days
50% drop in aging A/RClean Claim Rate
99.2%
Up from 83.0%"Synchronizing our surgeon billing with our ASC facility billing eliminated code discrepancies and increased our facility yield by 27%."
Dr. Richard Miller, MDMedical Director at Pinnacle Surgical Center
Actionable Takeaways for Practice Leaders
1
Synchronize surgeon professional CPT codes with ASC facility UB-04 revenue codes to avoid payer discrepancies2
Attach manufacturer implant invoices digitally to high-dollar surgical claims upon initial EDI dispatchReady to Achieve Similar Results?
Schedule a complimentary Revenue Cycle Audit for your practice to pinpoint billing leaks and clean claim opportunities.
Organization Profile
Organization:Pinnacle Surgical Center
Specialty:Orthopedic Surgery & ASC Facility
Location & Scale:Las Vegas, NV (14 Surgeons)
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