What Rho would find in your X-rays, and what it is worth.

Assumption X-ray studies your sites perform in a year, all ages and body parts. Example. Enter your own.

Assumption Gross volume divided by this gives the patients who had at least one X-ray. Within a single month, 16 Bit’s retrospective analyses counted 1.2 Rho-eligible X-ray studies per patient aged 50 and older at a multi-site imaging network (27,942 studies from 23,817 patients) and 1.3 Rho reads per patient at a 12-location orthopedic practice (2,792 reads from 2,146 patients). Over a full year patients return, so the annual figure is higher; 1.5 is an example. Set it from your own system. 16 Bit retrospective analyses, one month each, at a multi-site imaging network and a multi-site orthopedic practice, data on file.

Rho screens patients aged 50 and older. Across Rho installs, X-rays from patients aged 50 and older were 59% of all the X-rays Rho’s analytics counted (median 64%, range 52% to 76%; installs that query only patients 50 and older are left out). 16 Bit fleet data, 90 days ending on 2026-10-19, data on file.

Rho reads a frontal chest, thoracic spine, lumbar spine, pelvis, hand or wrist, or knee X-ray from patients with no DXA in the last two years (default; customizable). Overall, across Rho installs, Rho read 61% of the X-rays from patients aged 50 and older (median 71%). 16 Bit fleet data, 90 days ending on 2026-10-19, data on file.

Across Rho installs, 37% of the X-rays are Rho positive (median 37%, range 29% to 47%). 16 Bit fleet data, 90 days ending on 2026-10-19, data on file. Outside the United States, a report is sent at a Rho Score of 6 or more by default. At a large independent imaging facility, Rho flagged 19,004 of 34,162 X-rays (56%) over 13 months. Across Rho installs, 54% of the X-rays Rho read scored 6 or more (median 55%, range 47% to 70%). Syme et al., Skeletal Radiology, 2026 ↗

In a prospective academic hospital study, 125 of 655 Rho-positive patients (19%) had a DXA within six months. Jayarajah et al., CARJ, 2025 ↗

A blend of Medicare and commercial rates. Across Rho installs, 60% of the X-rays Rho reads are from patients aged 65 and older, so the blend takes 60% at the 2026 Medicare national rate and 40% at the commercial rates in Milliman’s benchmarking of 2022 claims: 141% of Medicare for professional services and 257% for outpatient facility services. For CPT 77080 (DXA, axial skeleton) that gives $45.87 USD in an office or freestanding center (Medicare pays $39.41 as a global payment: 1.18 RVUs at the $33.4009 conversion factor) and $184.77 USD in a hospital outpatient department (Medicare pays $116.16: APC 5522 at $106.81 plus the professional component of 0.28 RVUs). Choose the setting or enter your own blended rate. Milliman, commercial reimbursement benchmarking, 2022 ↗ Assumption Example. Fees differ by jurisdiction and payer. For reference, the Australian Medicare Benefits Schedule lists AUD 122.55 for a two-site DXA (item 12306, from 1 July 2026). Enter your own rate. Australian Medicare Benefits Schedule, item 12306 ↗

Assumption X-ray studies your sites perform in a year, all ages and body parts. Example. Enter your own.

Assumption Gross volume divided by this gives the patients who had at least one X-ray. Within a single month, 16 Bit’s retrospective analyses counted 1.2 Rho-eligible X-ray studies per patient aged 50 and older at a multi-site imaging network (27,942 studies from 23,817 patients) and 1.3 Rho reads per patient at a 12-location orthopedic practice (2,792 reads from 2,146 patients). Over a full year patients return, so the annual figure is higher; 1.5 is an example. Set it from your own system. 16 Bit retrospective analyses, one month each, at a multi-site imaging network and a multi-site orthopedic practice, data on file.

Rho screens patients aged 50 and older. Across Rho installs, X-rays from patients aged 50 and older were 59% of all the X-rays Rho’s analytics counted (median 64%, range 52% to 76%; installs that query only patients 50 and older are left out). 16 Bit fleet data, 90 days ending on 2026-10-19, data on file.

Rho reads a frontal chest, thoracic spine, lumbar spine, pelvis, hand or wrist, or knee X-ray from patients with no DXA in the last two years (default; customizable). At a 12-location orthopedic practice (16 Bit’s retrospective analysis of one month of imaging, April 2024), 36% of patients aged 50 and older with any imaging study had a view Rho can read. Overall, across Rho installs, Rho read 61% of the X-rays from patients aged 50 and older (median 71%). 16 Bit fleet data, 90 days ending on 2026-10-19, data on file.

In one month at a 12-location US orthopedic practice, Rho flagged 772 of 2,146 screened patients aged 50 and older (36%) as Rho Positive. Flags were not confirmed by DXA in that analysis. 16 Bit retrospective analysis at a multi-site orthopedic practice, 2026 In one month at a 12-location US orthopedic practice, Rho flagged 1,128 of 2,146 screened patients aged 50 and older (53%) at a Rho Score of 6 or more (the default score to flag low bone density outside the United States). Low bone density was not confirmed by DXA in that analysis. For comparison, across Rho installs (mostly imaging clinics rather than orthopedic clinics), 54% of the X-rays Rho read scored 6 or more. 16 Bit retrospective analysis at a multi-site orthopedic practice, 2026

Assumption The share of flagged patients your surgeons and advanced practice providers send to a bone health visit. This is your own pathway. Example.

When a spine program added a bone health optimization clinic, 89% of referred patients had their bone density measured, against 10% of those not referred. Bernatz et al., JAAOS Global Research and Reviews, 2022 ↗

In a validation set of 513 X-rays, where the prevalence of low bone density was similar to that of the general US population aged 50 and older, 143 of the 157 patients Rho flagged as Rho Positive (91%) had true low bone density (a DXA T-score < −1). The validation set is described in the FDA De Novo decision summary DEN230023 ↗; the predictive value is from 16 Bit’s analysis. Syme et al., ASBMR 2024, performance of Rho in US patients, data on file. At a large independent imaging facility, 258 of 297 DXAs prompted by a reported Rho finding (87%) had true low bone density (a DXA T-score < −1). Syme et al., Skeletal Radiology, 2026 ↗

At a large independent imaging facility, 65 of the 258 patients whose Rho-prompted DXA showed low bone density (25%) had osteoporosis (a T-score of −2.5 or lower), which meets the BHOF 2022 treatment criteria on its own. Patients with osteopenia also qualify if they have had a hip or vertebral fracture, or if their 10-year FRAX probability is 3% or more for hip fracture or 20% or more for major osteoporotic fracture (LeBoff et al., Osteoporosis International, 2022 ↗), so the share can be higher: 34% of all Rho-prompted DXAs at that facility showed moderate or high fracture risk (assessed by FRAX; Syme et al., Skeletal Radiology, 2026 ↗), as did 51% (64 of 125, our count from Table 2) in a prospective study at an academic hospital in Canada (assessed by CAROC; Jayarajah et al., CARJ, 2025 ↗). On preoperative CT, 31% of lumbar fusion patients had osteoporosis and 34% osteopenia (Köhli et al., NASSJ, 2025 ↗), so a surgical population can run higher still. At a large independent imaging facility, 65 of the 258 patients whose Rho-prompted DXA showed low bone density (25%) had osteoporosis (a T-score of −2.5 or lower), which on its own meets treatment criteria in guidelines such as BHOF 2022. Under BHOF 2022, patients with osteopenia also qualify if they have had a hip or vertebral fracture, or if their 10-year FRAX probability is 3% or more for hip fracture or 20% or more for major osteoporotic fracture (LeBoff et al., Osteoporosis International, 2022 ↗), so the share can be higher: 34% of all Rho-prompted DXAs at that facility showed moderate or high fracture risk (assessed by FRAX; Syme et al., Skeletal Radiology, 2026 ↗), as did 51% (64 of 125, our count from Table 2) in a prospective study at an academic hospital in Canada (assessed by CAROC; Jayarajah et al., CARJ, 2025 ↗). On preoperative CT, 31% of lumbar fusion patients had osteoporosis and 34% osteopenia (Köhli et al., NASSJ, 2025 ↗), so a surgical population can run higher still.

In the same spine program (see “DXA done” assumption), every referred patient who met treatment criteria was treated before surgery, against 25% of those not referred. Bernatz et al., JAAOS Global Research and Reviews, 2022 ↗

CPT 99214 (established patient visit, moderate complexity), non-facility: 4.06 RVUs at the 2026 conversion factor of $33.4009. This equates to $135.61 USD. Enter your own blended rate. CMS 2026 Medicare physician fee schedule ↗ Assumption Example from the United States: CPT 99214 (established patient visit, moderate complexity), non-facility: 4.06 RVUs at the 2026 conversion factor of $33.4009, about $136 USD. Enter your own rate. CMS 2026 Medicare physician fee schedule ↗

A blend of Medicare and commercial rates. Across Rho installs, 60% of the X-rays Rho reads are from patients aged 65 and older, so the blend takes 60% at the 2026 Medicare national rate and 40% at the commercial rates in Milliman’s benchmarking of 2022 claims: 141% of Medicare for professional services and 257% for outpatient facility services. For CPT 77080 (DXA, axial skeleton) that gives $45.87 USD in an office or freestanding center (Medicare pays $39.41 as a global payment: 1.18 RVUs at the $33.4009 conversion factor) and $184.77 USD in a hospital outpatient department (Medicare pays $116.16: APC 5522 at $106.81 plus the professional component of 0.28 RVUs). Choose the setting or enter your own blended rate. Milliman, commercial reimbursement benchmarking, 2022 ↗ Assumption Example. Fees differ by jurisdiction and payer. For reference, the Australian Medicare Benefits Schedule lists AUD 122.55 for a two-site DXA (item 12306, from 1 July 2026). Enter your own rate. Australian Medicare Benefits Schedule, item 12306 ↗

Assumption The share of DXAs done on your own scanner rather than referred out. Set to zero if you have no scanner. Example.

Assumption Injection or infusion administration and treatment monitoring, where you provide them. Enter your own figure; left at zero, treatment starts are counted but not valued.

Assumption The share of treated patients who go on to arthroplasty or spinal fusion. This depends on your case mix. Example.

In 41,995 hip and knee replacements, patients on bisphosphonates had a five-year revision rate of 0.93% against 1.96%, about 1 percentage point lower. Observational. For long spinal fusions, reoperation was 11.5% with teriparatide against 23.1% in untreated patients with osteopenia (Mohanty et al., JBJS, 2024 ↗). Prieto-Alhambra et al., BMJ, 2011 ↗

Your site may bear only part of this cost (set in the next assumption). Hospital cost of a periprosthetic femur fracture admission in the US National Inpatient Sample, 2013 to 2015: about $31,000 USD for hips and $28,000 for knees. $30,000 in 2013 to 2015 dollars is about $39,000 in 2025 dollars (BEA PCE hospitals price index). Ragland et al., Geriatric Orthopaedic Surgery and Rehabilitation, 2020 ↗

Assumption Most health systems and practices are paid fee-for-service: when a fracture or a revision happens, it is the payer that bears the cost, and treating it is revenue for the provider. Avoided costs come back to you only where you bear them: shared savings in a Medicare accountable care organization, Medicare Advantage capitation or a full-risk contract, a health plan you own, or your own self-insured employees. Set the share you bear; it is zero by default. It applies to the revision costs avoided.

Assumption X-ray studies your sites perform in a year, all ages and body parts. Example. Enter your own.

Assumption Gross volume divided by this gives the patients who had at least one X-ray. Within a single month, 16 Bit’s retrospective analyses counted 1.2 Rho-eligible X-ray studies per patient aged 50 and older at a multi-site imaging network (27,942 studies from 23,817 patients) and 1.3 Rho reads per patient at a 12-location orthopedic practice (2,792 reads from 2,146 patients). Over a full year patients return, so the annual figure is higher; 1.5 is an example. Set it from your own system. 16 Bit retrospective analyses, one month each, at a multi-site imaging network and a multi-site orthopedic practice, data on file.

Rho screens patients aged 50 and older. Across Rho installs, X-rays from patients aged 50 and older were 59% of all the X-rays Rho’s analytics counted (median 64%, range 52% to 76%; installs that query only patients 50 and older are left out). 16 Bit fleet data, 90 days ending on 2026-10-19, data on file.

Rho reads a frontal chest, thoracic spine, lumbar spine, pelvis, hand or wrist, or knee X-ray from patients with no DXA in the last two years (default; customizable). Overall, across Rho installs, Rho read 61% of the X-rays from patients aged 50 and older (median 71%). 16 Bit fleet data, 90 days ending on 2026-10-19, data on file.

Across Rho installs, 37% of the X-rays are Rho positive (median 37%, range 29% to 47%). 16 Bit fleet data, 90 days ending on 2026-10-19, data on file. Outside the United States, a report is sent at a Rho Score of 6 or more by default. At a large independent imaging facility, Rho flagged 19,004 of 34,162 X-rays (56%) over 13 months. Across Rho installs, 54% of the X-rays Rho read scored 6 or more (median 55%, range 47% to 70%). In a prospective study at Sunnybrook Health Sciences Centre, the rate was 66% (Jayarajah et al., CARJ, 2025 ↗). Syme et al., Skeletal Radiology, 2026 ↗

In a prospective academic hospital study, 125 of 655 Rho-positive patients (19%) had a DXA within six months. Jayarajah et al., CARJ, 2025 ↗

In a validation set of 513 X-rays, where the prevalence of low bone density was similar to that of the general US population aged 50 and older, 143 of the 157 patients Rho flagged as Rho Positive (91%) had true low bone density (a DXA T-score < −1). The validation set is described in the FDA De Novo decision summary DEN230023 ↗; the predictive value is from 16 Bit’s analysis. Syme et al., ASBMR 2024, performance of Rho in US patients, data on file. At a large independent imaging facility, 258 of 297 DXAs prompted by a reported Rho finding (87%) had true low bone density (a DXA T-score < −1). Syme et al., Skeletal Radiology, 2026 ↗

At a large independent imaging facility, 65 of the 258 patients whose Rho-prompted DXA showed low bone density (25%) had osteoporosis (a T-score of −2.5 or lower), which meets the BHOF 2022 treatment criteria on its own. Patients with osteopenia also qualify if they have had a hip or vertebral fracture, or if their 10-year FRAX probability is 3% or more for hip fracture or 20% or more for major osteoporotic fracture (LeBoff et al., Osteoporosis International, 2022 ↗), so the share can be higher: 34% of all Rho-prompted DXAs at that facility showed moderate or high fracture risk (assessed by FRAX; Syme et al., Skeletal Radiology, 2026 ↗), as did 51% (64 of 125, our count from Table 2) in a prospective study at an academic hospital in Canada (assessed by CAROC; Jayarajah et al., CARJ, 2025 ↗). At a large independent imaging facility, 65 of the 258 patients whose Rho-prompted DXA showed low bone density (25%) had osteoporosis (a T-score of −2.5 or lower), which on its own meets treatment criteria in guidelines such as BHOF 2022. Under BHOF 2022, patients with osteopenia also qualify if they have had a hip or vertebral fracture, or if their 10-year FRAX probability is 3% or more for hip fracture or 20% or more for major osteoporotic fracture (LeBoff et al., Osteoporosis International, 2022 ↗), so the share can be higher: 34% of all Rho-prompted DXAs at that facility showed moderate or high fracture risk (assessed by FRAX; Syme et al., Skeletal Radiology, 2026 ↗), as did 51% (64 of 125, our count from Table 2) in a prospective study at an academic hospital in Canada (assessed by CAROC; Jayarajah et al., CARJ, 2025 ↗).

Among women found to have osteoporosis on DXA, 63% were on treatment after the scan, against 15% before. Across fracture liaison services, treatment initiation was 38% with a program and 17% without (Wu et al., Bone, 2018 ↗). Fitt et al., CMAJ, 2001 ↗

As a share of flagged patients. In a prospective hospital study, 36% of Rho-positive patients said they had discussed bone health with their primary care provider within six months, against 18% of Rho-negative patients. The difference is the closest available estimate of what a Rho flag adds, but the study cannot prove cause and effect: flagged patients were at higher risk, and 389 of 987 patients answered the follow-up. Set this to the share you expect to book a visit or fracture risk assessment. Jayarajah et al., CARJ, 2025 ↗

Patients who meet the treatment criteria have a 10-year probability of a major osteoporotic fracture of 20% or more, or qualify on T-score or a prior fracture. 20% is the treatment threshold, so it is a floor for this group. LeBoff et al., Osteoporosis International, 2022 ↗

In a meta-analysis of 13 trials with 11,822 patients, bisphosphonates reduced the odds of new vertebral fractures to 0.56, hip fractures to 0.69 and other nonvertebral fractures to 0.82, against placebo. 30% is an estimate. The trials were in patients with a prior fracture. Shi et al., BioMed Research International, 2019 ↗

Added medical cost to Medicare in the year after a new osteoporotic fracture: $21,600 USD in 2016 claims, about $26,500 in 2025 dollars (BEA PCE health care price index). Costs in later years, and to patients, are not counted. Milliman, 2021 ↗

42% of Medicare fee-for-service beneficiaries with a new osteoporotic fracture were admitted to hospital within seven days, in 2016 claims. Milliman, 2021 ↗

Mean length of stay in 268,477 admissions for an osteoporosis-related fracture in adults aged 50 and older at 548 US hospitals, 2010 to 2013: 5.1 days (hip 5.6, spine 5.4, other non-spine fractures 4.0). Over half were then discharged to skilled nursing or long-term care; those days are not counted. Weycker et al., Bone Reports, 2016 ↗

Assumption The share of treated patients who have a hip or knee replacement or a spinal fusion in your system within five years. Depends on your surgical volume and case mix. Example.

In 41,995 hip and knee replacements, patients on bisphosphonates had a five-year revision rate of 0.93% against 1.96%, about 1 percentage point lower. Observational. For long spinal fusions, reoperation was 11.5% with teriparatide against 23.1% in untreated patients with osteopenia (Mohanty et al., JBJS, 2024 ↗). Prieto-Alhambra et al., BMJ, 2011 ↗

Your site may bear only part of this cost (set in the next assumption). Hospital cost of a periprosthetic femur fracture admission in the US National Inpatient Sample, 2013 to 2015: about $31,000 USD for hips and $28,000 for knees. $30,000 in 2013 to 2015 dollars is about $39,000 in 2025 dollars (BEA PCE hospitals price index). Ragland et al., Geriatric Orthopaedic Surgery and Rehabilitation, 2020 ↗

Assumption Most health systems and practices are paid fee-for-service: when a fracture or a revision happens, it is the payer that bears the cost, and treating it is revenue for the provider. Avoided costs come back to you only where you bear them: shared savings in a Medicare accountable care organization, Medicare Advantage capitation or a full-risk contract, a health plan you own, or your own self-insured employees. Set the share you bear; it is zero by default. It applies to the fracture and revision costs avoided.

CPT 99214 (established patient visit, moderate complexity), non-facility: 4.06 RVUs at the 2026 conversion factor of $33.4009. This equates to $135.61 USD. Enter your own blended rate. CMS 2026 Medicare physician fee schedule ↗ Assumption Example from the United States: CPT 99214 (established patient visit, moderate complexity), non-facility: 4.06 RVUs at the 2026 conversion factor of $33.4009, about $136 USD. Enter your own rate. CMS 2026 Medicare physician fee schedule ↗

A blend of Medicare and commercial rates. Across Rho installs, 60% of the X-rays Rho reads are from patients aged 65 and older, so the blend takes 60% at the 2026 Medicare national rate and 40% at the commercial rates in Milliman’s benchmarking of 2022 claims: 141% of Medicare for professional services and 257% for outpatient facility services. For CPT 77080 (DXA, axial skeleton) that gives $45.87 USD in an office or freestanding center (Medicare pays $39.41 as a global payment: 1.18 RVUs at the $33.4009 conversion factor) and $184.77 USD in a hospital outpatient department (Medicare pays $116.16: APC 5522 at $106.81 plus the professional component of 0.28 RVUs). Choose the setting or enter your own blended rate. Milliman, commercial reimbursement benchmarking, 2022 ↗ Assumption Example. Fees differ by jurisdiction and payer. For reference, the Australian Medicare Benefits Schedule lists AUD 122.55 for a two-site DXA (item 12306, from 1 July 2026). Enter your own rate. Australian Medicare Benefits Schedule, item 12306 ↗

Assumption Injection or infusion administration and treatment monitoring, where you provide them. Enter your own figure; left at zero, treatment starts are counted but not valued.