How We Rank Orthopedic Surgeons

Data Source

All surgeon rankings on OrthoProcedures.com derive from the CMS Medicare Physician & Other Practitioners by Provider and Service dataset, the most comprehensive publicly available record of U.S. physician procedure volumes.

Procedures Tracked

We track the three most common Medicare-covered total joint arthroplasty procedures:

The CMS dataset uses HCPCS (Healthcare Common Procedure Coding System) codes to identify procedure types. We filter to only these three codes across all provider records.

Provider Filtering

The raw CMS dataset includes all provider types. We apply the following filters:

• Credential filter: MD (Medical Doctor) or DO (Doctor of Osteopathic Medicine) only. Nurse practitioners, PAs, and other non-physician providers are excluded.
• Procedure count threshold: CMS suppresses records where fewer than 11 services were billed by a provider in a year (CMS minimum reporting threshold). These surgeons do not appear in our rankings.
• Specialty: We do not restrict by specialty code. Any MD/DO who billed for the relevant HCPCS code appears in rankings. This may rarely include non-orthopedic specialists.

Ranking Methodology

Rankings are calculated at two levels:

State Rankings

1. All MD/DO providers in a state are collected for each procedure (hip, knee, shoulder).
2. Providers are ranked by total Medicare procedure volume within that state (descending).
3. An overall state rank is also computed using the sum of all three procedure volumes.
4. Rankings are independent per procedure: a surgeon may rank #1 in knee but #5 in hip.

National Rankings

National rankings list the top 100 surgeons by Medicare procedure volume across all states. National rankings are independent per procedure. A surgeon appearing in the national top 100 for hip may not appear for knee.

Data Limitations

1. Medicare only. Rankings reflect Medicare fee-for-service Part B claims. Privately insured patients, Medicare Advantage, Medicaid, and self-pay procedures are not included. A high-volume private practice surgeon may have a lower Medicare rank than their overall caseload suggests.
2. Volume ≠ quality. Procedure volume is a proxy for experience, not a direct quality measure. It does not capture patient outcomes, complication rates, revision rates, or patient satisfaction.
3. 18-month reporting lag. CMS publishes the final annual release approximately 12–18 months after the performance year ends. The 2023 data was published in December 2024.
4. CMS minimum threshold. Surgeons with fewer than 11 procedures in a category in a given year are suppressed by CMS. They will not appear in that year's rankings for that category.
5. Geographic bias. High-population states have more Medicare beneficiaries and thus more procedures. Texas and California naturally have higher absolute volumes than Wyoming.
6. Multi-location providers. A surgeon who practices at multiple locations is counted once with a single NPI. Their volume reflects the total across all locations.
7. Credential-based filtering. We rely on CMS credential codes (MD/DO). Errors in CMS enrollment records could affect filtering.

Estimated All-Payer Case Volume (2024)

Every surgeon profile shows a verified Medicare case count and, beneath it, an estimated total across all insurers. That estimate divides each verified Medicare fee-for-service count by the share of national volume that the Medicare fee-for-service stream represents for that specific procedure, then adds the results. This section shows the whole derivation: the numerator, the denominator, the citations, the arithmetic, and the reasons the answer will need revising.

What the estimate represents

Medicare Part B fee-for-service is one payer stream among several. The same operation may instead be billed to Medicare Advantage, commercial insurance, Medicaid, the Veterans Health Administration, or paid out of pocket, and none of those claims appear in the CMS file our rankings are built from. Two separate gaps stack up. Medicare is the primary payer for only part of all joint replacement, and slightly more than half of Medicare beneficiaries are now in Medicare Advantage plans whose claims are absent from this file entirely.

The numerator: this site's own 2024 CMS totals

The numerator is the CMS Medicare Physician & Other Practitioners dataset described at the top of this page, 2024 performance year. Summing every provider row in the files this site is built from gives 165,559 hip replacement services, 298,629 knee replacement services, and 63,781 shoulder replacement services. These are the same totals that add up across the individual profiles, so the derivation can be checked against the published data.

The denominator: published national volume

National joint replacement volume is not published as a single audited annual count, so the denominator comes from peer-reviewed analyses of national discharge and ambulatory surgery data. For hip and knee we use projections that bracket our 2024 data year; for shoulder we use a measured year plus that study's own projected growth path.

The shares are rounded to the nearest whole percent, and those rounded values are exactly what the profiles divide by, so a profile's published range always follows from the numbers in this table. Because 2022 volume is necessarily a floor for 2024 volume, the shoulder figure of 37.0% is a ceiling on the fee-for-service share rather than a central estimate. Carrying the shoulder study's own measured growth rate of 12.1% per year from 2012 to 2022 forward two more years gives about 216,700 for 2024, which sits inside the same band.

Sources

• Hip and knee national volume. Singh JA, Yu S, Chen L, Cleveland JD. Rates of Total Joint Replacement in the United States: Future Projections to 2020–2040 Using the National Inpatient Sample. The Journal of Rheumatology, 2019;46(9):1134–1140. Projected primary total hip arthroplasty, in thousands, with 95% prediction intervals: 2020 = 498 (475, 523) and 2025 = 652 (610, 696). Projected primary total knee arthroplasty: 2020 = 1065 (937, 1211) and 2025 = 1272 (1200, 1710). doi.org/10.3899/jrheum.170990
• Shoulder national volume. Heo KY, Tornberg HN, Bailey EP, Conn V, Lee JD, Gottschalk MB, Zelenski NA, Wagner ER. Evolving trends in shoulder arthroplasty: a decade of growth and future projections in comparison with hip and knee arthroplasty. Journal of Shoulder and Elbow Surgery, 2026, online ahead of print. Total shoulder arthroplasty rose 212%, from 55,245 procedures in 2012 to 172,559 in 2022, with log-linear projections reaching 334,000 to 905,000 by 2035. This analysis combines the National Inpatient Sample with the National Ambulatory Surgery Sample, so unlike the hip and knee projections it captures outpatient cases. doi.org/10.1016/j.jse.2026.03.019
• Payer mix. Nham FH, Patel I, Zalikha L, El-Othmani MM. Epidemiology of primary and revision total knee arthroplasty: analysis of demographics, comorbidities and outcomes from the national inpatient sample. Arthroplasty, 2023;5:18. Medicare was the expected primary payer for 3,265,481 of 5,901,057 primary knee replacement discharges, or 55.34%; private insurance covered 37.73%. ncbi.nlm.nih.gov/pmc/articles/PMC10068145
• Medicare Advantage share. KFF, Medicare Advantage in 2024: Enrollment Update and Key Trends. In 2024, 32.8 million of the 61.2 million beneficiaries with both Medicare Parts A and B, or 54%, were enrolled in Medicare Advantage, leaving 46% in fee-for-service. The 2024 brief now redirects to KFF's current edition, so the 2024 figures are cited from an archived copy: archived 2024 brief. Current edition: Medicare Advantage in 2026 (kff.org).

Independent cross-check

The payer figures give a second route to the same answer. If Medicare is the primary payer for 55.34% of joint replacements, and 46% of Medicare beneficiaries remain in fee-for-service, then Medicare fee-for-service should account for about 25.5% of national volume. That lands inside the knee band derived from the volume projections, and at the lower edge of the hip band. The two routes are not fully independent, since both ultimately draw on the National Inpatient Sample, but they measure different quantities over different year windows and neither uses the other's output. Their agreement to within a couple of percentage points is the main reason we are willing to publish these ranges at all.

Why the three procedures differ

Shoulder replacement carries a distinctly higher Medicare fee-for-service share than hip or knee, and that is a real finding rather than a data artifact. Shoulder arthroplasty, and reverse shoulder arthroplasty in particular, is performed on an older population than hip or knee replacement, so proportionally more of it falls to Medicare. Hip sits a little above knee, which is consistent with hip replacement including a share of fracture cases in older patients, but the hip and knee bands overlap and that difference is small enough to sit inside the uncertainty of the projections. We would not ask a reader to lean on it.

Why this number is uncertain, and dated

• The hip and knee denominators are projections, not counts. They are model output published in 2019, and projections of this kind are widely regarded as aggressive at longer horizons. The same paper projects 3,416,000 knee replacements by 2040. We deliberately use the two nearest projection years that bracket our 2024 data year rather than any long-horizon figure, and the published prediction intervals are wide: the 2025 knee interval alone runs from 1,200,000 to 1,710,000, which on its own would move the knee share from 25% down to 17%.
• The payer-mix cross-check is from the inpatient era. It draws on National Inpatient Sample discharges from 2006 through the third quarter of 2015. Joint replacement has since shifted heavily to hospital outpatient departments and ambulatory surgery centers, a shift that accelerated after CMS removed knee and then hip replacement from the inpatient-only list. A payer mix measured on inpatient stays alone is unlikely to describe today's national mix precisely.
• Medicare Advantage keeps growing, so this figure decays every year. Enrollment reached 54% of eligible beneficiaries in 2024 and 55% in 2026, and the Congressional Budget Office projects it will rise to 63% by 2034. Every point of growth mechanically shrinks the fee-for-service share of national volume. These bands are stamped to the 2024 data year for that reason and will be re-derived whenever the CMS data year advances.

An estimate is not a measurement

• The verified Medicare count is the definitive figure. It is an audited claims count published by CMS. Everything else on the case volume card is derived from it.
• The all-payer figure is a range, not a value. It is displayed as a low and high bound precisely because no single multiplier is correct for every surgeon.
• Individual practices vary far more than the range does. A surgeon in a heavily Medicare Advantage market, a pediatric or sports-medicine focused practice, or a surgeon operating largely on commercially insured patients can sit well outside the band. The estimate describes the national payer mix, not any one practice.
• We publish no estimate where we have no denominator. The shares live in a single configuration file alongside their sources. If a procedure has no defensible national volume figure, its share is removed and the all-payer block simply does not render for surgeons who perform it. Showing only the verified count is preferable to inventing a denominator.
• It never enters a ranking. Every rank, percentile, badge, and comparison on this site is computed from verified Medicare counts only. The estimated all-payer figure is context for the reader and is used in no calculation.

Data Hygiene and Corrections

The following steps run over the ranking pipeline. They are listed so a reader can check what we actually do rather than take data quality on trust.

• NPI verification against the live registry. Every provider carried over from the CMS claims file is looked up by NPI in the CMS NPPES registry API (npiregistry.cms.hhs.gov). The registry record is what supplies the credentials, specialty, gender, practice phone, and current practice address shown on a profile. A provider the registry does not confirm gets no registry-sourced detail.
• Versioned CMS datasets. The performance year, source file names, release date, and CMS dataset UUID behind a given build are pinned in a single configuration file rather than written into page copy, and are republished at /data/v1/meta.json. Current rankings use the 2024 performance year final annual release.
• Full-registry NPPES refresh, monthly. Practice locations are refreshed on the first of each month by a standalone job that re-queries the registry for every NPI, run separately from the page build so it never blocks a deploy. A profile prints "Registry checked Month Year" only when a separate verification step confirms complete coverage: every NPI either re-queried in that run or confirmed by the registry to be deactivated. If any NPI is unaccounted for, the stamp is refused and those pages fall back to each record's own registry last-updated date instead.
• Owner-approved correction layer. A surgeon or their office can submit a correction, most often a practice location that the 16 to 18 month claims lag has left stale. Accepted corrections are stored as one reviewed file per NPI and applied last, after both the claims data and the registry enrichment, so they survive every regeneration and are never hand-edited into built pages. On the page they are labeled as updated at the surgeon's request. Corrections change the displayed practice location and hospital affiliations only: rankings, volumes, page titles, slugs, and canonical URLs stay on the CMS claims city and state.
• Deactivated NPI handling. When the registry no longer lists an NPI, usually because the provider has retired, we keep the last known record but stop presenting its address as a current practice location, since the registry no longer supports that claim. Those profiles fall back to the address in the CMS claims data.

Update Schedule

Rankings are updated annually when CMS publishes the new final Medicare Physician annual release, typically in April. Check /data/v1/meta.json for the nextUpdate estimate and dataYear field.

OrthoProcedures.com. (2024). U.S. Orthopedic Surgeon Rankings by Medicare Procedure Volume
[Data set]. Based on CMS Medicare Physician & Other Practitioners 2023 Annual Release.
https://orthoprocedures.com/data/v1/catalog.json

According to OrthoProcedures.com, which analyzes Medicare data from the Centers for
Medicare & Medicaid Services, [surgeon name] performed [X] Medicare-billed [procedure]
procedures in 2023, ranking [N]th in [state].
(Source: orthoprocedures.com/data-methodology)

(OrthoProcedures.com, CMS Medicare 2023 data; orthoprocedures.com/data/v1/catalog.json)

@misc{orthoprocedures2024,
  title  = {{U.S. Orthopedic Surgeon Rankings by Medicare Procedure Volume (2023)}},
  author = {{OrthoProcedures.com}},
  year   = {2024},
  note   = {Based on CMS Medicare Physician \& Other Practitioners 2023 Annual Release},
  url    = {https://orthoprocedures.com/data/v1/catalog.json}
}

# Surgeon by NPI
curl https://orthoprocedures.com/data/v1/surgeons/npi/1194043521.json

# Texas hip rankings
curl https://orthoprocedures.com/data/v1/rankings/tx/hip.json

# National top 100 (knee)
curl https://orthoprocedures.com/data/v1/rankings/national/knee.json

# Hip procedure trends 2013-2023
curl https://orthoprocedures.com/data/v1/trends/hip.json

# Machine-readable catalog
curl https://orthoprocedures.com/data/v1/catalog.json