Featured Case Study
Surgery
Surgical billing software built for what happens in the OR.
Bring surgical, payer, and payment intelligence into the workflow before modifiers, bundling, sequencing, or global logic become downstream rework.
Trusted by 130K+ providers · 500M annual transactions
The problem
The procedure is only part of the claim.
Modifiers 50, 51, 55, 62, 66, and 79 can change who gets paid, what gets paid, and how multiple services are evaluated.
Postoperative care, unrelated procedures, and transferred care need to line up with the surgical episode—not just the individual charge.
Multiple procedures performed together can trigger CCI edits, MUEs, surgical tray logic, microscope billing, and other bundling requirements.
Bariatric, reconstructive, MIGS, joint replacement, cervical fusion, and other procedures bring payer-specific medical-necessity requirements.
Co-surgeons, assistants, and surgical teams introduce another layer of modifier and reimbursement logic before the claim leaves.
Key features & benefits
Resolve surgical risk while the charge can still change.
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Review up to 75% less
Resolve routine charge findings automatically and let clean encounters keep moving, so staff spend less time on predictable corrections.
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Escalate what matters
Route documentation-dependent and higher-risk findings to the people equipped to resolve them instead of building another undifferentiated work queue.
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86 surgery checks
Apply procedure-specific logic across modifiers, global periods, coverage, bundling, units, laterality, co-surgeon billing, and team surgery.
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Sharper with every outcome
Use claims, remittances, and payer signals across the market to identify what changed, validate the pattern, and improve the next reimbursement decision.
By the numbers
Proven in complex procedural care.
Every metric tracked. Every dollar recovered.
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80%
of charges moved touchless
A plastic surgery practice moved routine charge corrections out of staff queues.
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76%
faster charge processing
Newport Ortho accelerated charge processing with 70% autocorrect.
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$37M
in savings found
An orthopedics PM/EHR found missing opportunity in surgical claims.
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60%
of corrections automated
Jackson Heart cut manual review across 10,500 monthly encounters, no added FTEs.
“Aptarro provides a clear picture of how much work is being fixed before it ever becomes a problem, which is invaluable for keeping leadership informed.”
The Aptarro Platform
Reimbursement intelligence for surgical billing.
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RemitIntel
The remittance learning layer
50%avoidable denial reduction
Identify patterns from real payment outcomes and policy signals with network intelligence to sharpen new rules and get smarter with every outcome.
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RCx
The pre-claim optimizer
75%less manual review
Catches and corrects billing and coding errors before claims are created — logic for 36+ specialties.
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ClaimStaker
The industry's most complete claim scrubber
4A/R days removed
Find what stops payment before claims reach the payer.
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HCC
The real-time HCC code reviewer
$6MRAF value, year one
Guide coders to cases with the greatest RAF impact.
Explore HCC →
Common questions
What teams ask us.
Answered clearly, without the sales pitch.
What makes surgical billing especially difficult?
A single surgical encounter can involve multiple procedures, modifiers, global-period rules, medical-necessity requirements, bundling logic, and different provider roles. Those decisions have to remain aligned from charge capture through claim submission.
What surgical logic does RCx include?
Current content includes payer coverage and medical necessity, surgical modifiers, global logic, bundling, MUEs, units, diagnosis requirements, laterality, co-surgeon billing, and team surgery.
Can RCx review surgical modifiers?
Yes. Surgery-specific logic includes modifiers such as 50, 51, 55, 62, 66, and 79, along with related postoperative and shared-surgery scenarios.
How does Aptarro handle medical necessity for surgery?
Surgical claims can be evaluated against Medicare, Medicaid, commercial payer, LCD/NCD, and other applicable coverage logic before submission.
Does ClaimStaker support both professional and institutional surgical claims?
Yes. ClaimStaker supports professional and institutional claim editing, including payer-specific edits, CCI, LCD/NCD, MUE, medical necessity, and proprietary content.
Can we apply our own surgical billing requirements?
Yes. RCx can combine maintained content with logic specific to your payer mix, contracts, providers, locations and internal standards.
How does RemitIntel help with surgical denials?
RemitIntel uses remittance outcomes from across the Aptarro network for recurring payer behavior involving areas such as bundling, modifiers, frequency, sequencing, and coverage. Validated signals can inform new reimbursement logic before the same pattern keeps repeating.
Payment precision.
Find risk earlier and learn from every payment outcome.
Request a demo20+ EHR/PM integrations · 36+ specialties out-of-the-box