Case study: Surgical Implant Cost Management

Procedure type

Shoulder repair

What Paradigm’s audit found

• Determined the provider had been routinely cited for excessive implant pricing
• 5 suture anchors were billed as a misleading “unit of 1”; only 4 of the anchors were actually implanted; 5th was explanted
• Each anchor has a list cost of $287, but each was billed at $750 plus a 20% markup

Total billed charges

$7,496

Paradigm recommended allowable

$1,964

Savings

$5,532 or 73%