How to Choose an Orthopedic Surgeon: Subspecialties and Questions Before Surgery

What orthopedic surgeons do

The NUCC Health Care Provider Taxonomy, the code set used in NPI records, describes an orthopaedic surgeon as trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. NUCC lists conditions such as congenital deformities, trauma, infections, tumors and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow, in children and adults.

The definition includes medical and physical means, not only surgery. Many visits to an orthopedic practice end with a plan that does not involve an operation.

Orthopedic subspecialties

NUCC lists subspecialty codes that an orthopedic surgeon can register in the NPI record. A profile on this site shows those codes; they are chosen by the surgeon and are a starting point, not proof of fellowship training.

Joint replacement (adult reconstructive surgery)

NUCC describes adult reconstructive orthopaedic surgeons as dealing with procedures such as hip and knee joint replacement (arthroplasty), osteotomy, arthroscopy and soft-tissue reconstruction.

Spine

Orthopaedic spine surgeons, per NUCC, evaluate and treat, with and without surgery, the full spectrum of spinal disorders, including trauma, degenerative disease, deformity and tumors. NUCC's definition of neurological surgery covers disorders of the nervous system and its supporting structures, so for back or neck surgery you may meet either an orthopaedic or a neurological surgeon.

Sports medicine

NUCC describes an orthopaedic surgeon trained in sports medicine as caring for the musculoskeletal structures affected by sports, including conditioning, injury management and coordination of care with other health professionals.

Hand, foot and ankle, trauma and pediatrics

NUCC also lists hand surgery (the hand, wrist and other upper-extremity structures that affect them), foot and ankle surgery, orthopaedic trauma (acute injuries, fractures that heal poorly and complex pelvic fractures) and pediatric orthopaedic surgery (problems in infants, children and adolescents, such as scoliosis, club foot and broken bones).

Surgeon, sports medicine physician or physical therapist

Three kinds of clinicians commonly see people with joint, muscle and back problems:

• Orthopedic surgeon: evaluates the problem, may order imaging, and can treat it with or without surgery.
• Non-surgical sports medicine physician: NUCC lists sports medicine as a subspecialty of family medicine, internal medicine, pediatrics, emergency medicine and physical medicine and rehabilitation, with definitions that include the prevention and management of injury. These physicians are not surgeons; ask the practice which conditions it treats and when it refers to a surgeon.
• Physical therapist: NUCC describes physical therapists as licensed health care professionals who diagnose and treat people with conditions that limit their ability to move and perform daily activities. Medicare.gov's physical therapy page says Part B helps pay for medically necessary outpatient physical therapy when your doctor or another health care provider, including a nurse practitioner, clinical nurse specialist or physician assistant, certifies that you need it. There is no yearly limit on what Medicare pays for medically necessary outpatient therapy, and after the deductible you pay 20% of the Medicare-approved amount.

Which one to see first depends on the problem and your plan's rules. Your primary care clinician can help you decide, and our guide to referrals explains when your plan requires one.

What Medicare Part B data show about a surgeon's procedures

Orthopedic surgeon profiles on this site often include a Medicare Part B section built from CMS's Medicare Physician & Other Practitioners - by Provider and Service dataset. For each year we have loaded, it lists the service codes the surgeon billed to Original Medicare, such as office visits, injections and specific operations, with the number of services, the number of Medicare patients and the average amounts.

What the data can help with

• Seeing whether a surgeon billed Medicare for the kind of procedure you are considering in recent years.
• Getting a rough sense of how often, among Original Medicare patients, a surgeon performed it.
• Understanding typical Medicare allowed amounts for the surgeon's services. Our Part B billing guide explains these figures.

What the data do not show

CMS's methodology for the dataset sets the limits:

• Original Medicare only: procedures for patients with Medicare Advantage, private insurance or Medicaid are not counted, so a surgeon with mostly younger or privately insured patients may show low numbers.
• Small counts are hidden: any service provided to 10 or fewer Medicare patients in a year is excluded, so no row does not mean no experience.
• No outcomes: the data do not show results, complications, infections, revisions or patient experience. A high count is not a quality score.
• Past years: each release describes one past calendar year.

Use the counts as one input and ask the surgeon directly about experience and results.

Checking license and board certification

Every surgeon must hold a license in the state where you are treated. The FSMB lists every state medical board, and each profile on this site links to the board for the practice state; our license guide explains how to read a board record. Board certification is voluntary, separate from the license and not part of NPI or Medicare records, so this site cannot confirm it. Check Certification Matters for boards in the American Board of Medical Specialties, or, for osteopathic boards, use the search the American Osteopathic Association points patients to.

Second opinions

For a planned operation such as a joint replacement or spine surgery, a second opinion is a common step. Medicare.gov's page on second surgical opinions says that in some cases Part B covers a second opinion before medically necessary surgery that is not an emergency, and a third opinion if the first two differ. You pay your usual share of the Medicare-approved amount. Bring your imaging and the first surgeon's notes so the second surgeon can review the same information. Other plans have their own rules.

Questions before surgery

AHRQ's questions you should know include asking why you need a treatment, what the alternatives are, what the possible complications are, which hospital is best for your needs and how many times the surgeon has done the procedure. For orthopedic surgery you might add:

• What happens if I wait or try non-surgical treatment first?
• Where will the surgery be done, a hospital or a surgery center, and will I stay overnight?
• What will recovery look like, and how much physical therapy will I need?
• Who will do which parts of the operation?
• Do you accept Medicare assignment or my plan, and what will I owe for the surgeon, the facility and anesthesia?

Under Original Medicare, a surgeon who accepts assignment charges you only the deductible and coinsurance, as Medicare.gov's assignment page explains. AHRQ's patient tips also suggest asking for written instructions about what to do before and after a procedure.

Find an orthopedic surgeon near you

On T-MedInfo you can browse clinicians by state and city from the city listings below and open the orthopaedic surgery listing for your area, or search by name. On each profile, check the specialty codes, the Part B procedures, the practice address and the state board link, and confirm network status with your plan. Our specialist checklist covers the remaining steps.