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METHODS

We analyzed data from the Clinformatics DataMart (Eden Prairie, MN) on commercially insured patients undergoing 1 of 4 common elective orthopedic procedures from 2012 to 2017: arthroscopic meniscal repair, lumbar discectomy, total knee replacement, and total hip replacement. We constructed surgical care episodes beginning on the day of surgery and ending 30 days after surgery. The primary surgeon was defined as the surgeon whose Current Procedural Terminology code and date of service matched the principal procedure. When multiple surgeons submitted the same Current Procedural Terminology as the primary procedure, the primary surgeon was defined as the one with the highest insurance plan payment. We defined potential surprise bills as out-of-network charges in episodes in which the facility and primary surgeon were in-network, based on previously published studies. 2 We …