Malpractice Insurance for Orthopedic Surgeons

Orthopedic surgeons perform high-volume, high-stakes procedures that directly affect patient mobility and quality of life. From joint replacements and complex fracture repairs to spine surgery and sports medicine, the specialty’s mix of elective and trauma care creates significant malpractice exposure and requires purpose-built insurance.
Homewood Insurance secures orthopedic malpractice programs that reflect your real procedure mix—spine vs. no-spine, inpatient vs. ASC, trauma call, and sports coverage—plus the GL and ancillary protections your practice needs.
This page outlines the following:
- What Insurance Includes – a clear summary of Professional & General Liability for orthopedics.
- Cost of Coverage – typical annual premiums and key pricing drivers.
- Higher-Risk Procedures – surgeries that elevate premiums or require endorsements.
- Why Work With Homewood – how we tailor coverage to your practice.
Get a Free Quote Now
The fastest way to find the most suitable insurance coverage for orthopedic surgeons is to fill out our quick quote form, so we can give you an idea of the type of insurance coverage that best suits you.
Homewood Insurance works with a number of different carriers to ensure you have the most suitable insurance coverage at the best price.
Malpractice Insurance for Orthopedic Surgeons can include:
- Comprehensive protection for orthopedic and musculoskeletal surgical procedures.
- Includes spine surgery, fracture reductions, joint replacements, arthroscopies, and tendon repairs.
- Covers claims involving surgical site infection, implant complications, or nerve damage.
- Staff coverage for surgical assistants, PAs, RNs, and anesthesia teams.
- Legal defense coverage for professional license issues
- Limits up to $1M per claim / $3M aggregate with tail coverage available.
- Optional protection for sports medicine, trauma care, and spinal fusions.
Insurance for Orthopedic Surgeons can include:
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Professional Liability (Malpractice) Insurance
- Comprehensive protection for orthopedic and musculoskeletal surgery, including spine, fracture care, arthroplasty, arthroscopy, tendon/ligament/cartilage repairs, and hand/foot procedures.
- Defense and indemnity for allegations of wrong-site surgery, surgical site infection (SSI), nerve injury, vascular injury, malalignment, non-union, hardware failure, or DVT/PE management.
- Coverage for pre-op evaluation, surgical planning, intra-op technique, informed consent, and post-op follow-up/rehab coordination (including failure-to-refer claims).
- Applies in hospital, ASC, and office-based settings; includes vicarious liability for employed/contracted staff (PAs, NPs, RNs, CSTs, anesthesia teams by endorsement).
- License board and peer review defense; regulatory defense options for billing audits and CMS/Joint Commission inquiries.
- Available as claims-made (with tail/prior-acts) or occurrence (where offered). Standard limits up to $1,000,000 per claim / $3,000,000 aggregate; higher via excess.
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General Liability Insurance
- Third-party bodily injury/property damage unrelated to care (e.g., lobby slips, visitor injuries, equipment over-spray).
- Personal & advertising injury (defamation, disparagement).
- Medical payments and defense outside limits available on many forms.
- Separate occurrence limits for practice owners and multi-site groups; can be bundled in a BOP with property and business income.
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Recommended Add-Ons
- Cyber liability (ePHI/ PACS/EMR breaches; ransomware; notification/credit monitoring).
- Excess/Umbrella ($2M–$10M+) for hospitals requiring higher limits or for spine/trauma profiles.
- Employment Practices (EPLI) for hiring, harassment, discrimination, wage & hour (sublimited).
- Regulatory billing defense and Medicare/Medicaid audit endorsements.
- Medical director liability (if directing an ASC/clinic).
- Clinical trials/innovative device endorsements (subject to underwriting).
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Orthopedics – Surgery, No Spine: $25,000 – $70,000 (state & venue dependent).
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Orthopedics – Surgery with Spine: $60,000 – $150,000+ (NY/NJ/FL/IL metros at the top end).
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Non-operative/Office-based Ortho: $8,000 – $22,000 (sports med/IMEs only).
General Liability Insurance – Estimated Ranges:
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GL standalone: $600 – $2,500 per location (traffic, square footage, claims).
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BOP (GL + Property + Business Income): $1,400 – $6,000 depending on TIV, protection class, and equipment values (C-arms, scopes, sterilizers).
Common Add-On Pricing (indicative):
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Cyber Liability: $350 – $1,800 (records count, MFA/EDR controls).
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EPLI: $800 – $3,500 (headcount, turnover).
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Excess/Umbrella: $2,000 – $12,000 per $1M–$5M (risk tiered; spine/trauma higher).
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Regulatory Defense / Billing Audits: $500 – $2,000 (limits $25k–$100k).
Key Pricing Drivers
- Procedure mix: Any spine reclassifies to highest risk; heavy arthroplasty or trauma call increases rates.
- Venue: Urban/coastal venues (NYC, South FL, Cook County IL, LA) price higher than suburban/midwest.
- Claims history: Paid indemnity or multiple reserves can push accounts to E&S markets (often 1.5–3× admitted rates).
- Setting & throughput: High-volume ASC lists (infection/sterile turnover), teaching roles, or team coverage.
- Limits & form: Higher limits, occurrence, or consent-to-settle with “pure consent” can add cost.
- Tail: For claims-made, tail typically 150–250% of the expiring premium (one-time), often financed.





















Procedure Category | Description & Risks | Insurance Impact |
---|---|---|
Spine Surgery (Fusions, Laminectomies, Discectomies) | High severity exposure: neurological injury, paralysis, non-union, hardware failure, and large verdict potential. Even low-volume spine work reclassifies the practice. | +50–100% PL surcharge vs. no-spine surgical class; some carriers require higher limits or detailed case logs. |
Total Joint Arthroplasty (Hip/Knee/Shoulder) | Frequent allegations: SSI/PI, aseptic loosening, nerve injury, malalignment, leg-length discrepancy, or DVT/PE. | +20–40% PL increase with higher volume; infection-reduction protocols can earn credits. |
Arthroscopy & Sports (ACL, Rotator Cuff, Labrum) | Claims for residual instability, stiffness, CHL complex injuries, or missed pathology. Treating elite/pro athletes amplifies lost-earnings exposure. | +20–50% PL; endorsements or exclusions may apply for professional/elite athlete care or team physician services. |
Fracture Care & ORIF (Trauma Call) | Improper reduction, compartment syndrome, infection, or malunion/non-union allegations. Emergency settings raise severity. | +10–30% PL for heavy trauma mix; carriers review call schedules and ED volume. |
Foot/Ankle & Hand (Tendon/Nerve Repairs) | Nerve/tendon dysfunction, CRPS, stiffness, or chronic pain claims; high functional expectations. | +10–25% PL in high-volume subspecialty practices; documentation quality affects pricing. |
Outpatient/ASC High-Throughput Lists | Operational exposures (turnover, sterilization, discharge) heighten SSI and readmit risk; GL exposure from foot traffic. | Moderate PL/GL uptick; carriers may require ASC accreditation and infection benchmarks. |
Biologics/Adjuncts (Bone Graft Substitutes, PRP) | Product-related failure, off-label use, or unrealistic outcome expectations. | May need endorsements; +10–20% PL if central to practice and not manufacturer-covered. |
Other types of Insurance Orthopedic Surgeons need

General Liability Insurance

Business owner's policy (BOP) insurance

Professional Liability Insurance

Commercial Auto Insurance

Workers Compensation Insurance

Cyber Liability Insurance
Why Work With Homewood
- We place orthopedics nationwide across surgery-no-spine and spine classes, including trauma and sports profiles.
- Access to 100+ carriers (admitted & E&S) to keep pricing competitive in tough venues.
- We structure entity + individual limits, align ASC requirements, and layer excess where hospitals mandate higher limits.
- Proactive renewal strategy: we track venue shifts, nuclear verdict trends, and carrier appetite to avoid surprises.
Call 947-274-3093 or
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Ralph Schiller
Ralph specializes in sourcing the most suitable insurance for Orthopedic Surgeons at the best price. You can call him or fill out the form and he will get your message directly.