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About Tier 1 Institute Orthopedics

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No physician referrals required.

About Orthopedics

#1 in Tennessee for Overall Orthopedic Services

For more than three decades, Tier 1 Orthopedics (formerly Upper Cumberland Orthopedic Surgery) has specialized in the care of our patients' musculoskeletal systems, bones, joints, ligaments, muscles, nerves and related structures of arms, legs, back, and pelvis. Tier 1 Orthopedics has board-certified orthopedic surgeons, each one with mature judgment, successful experience and high qualifications. They have gathered about them professional staff members who share their necessary commitment to leading-edge orthopedic and related care.

Our goal is simply to return patients to normal function as quickly and safely as possible. To reach this goal, the medical professionals of Tier 1 Orthopedics enlist a comprehensive, leading-edge approach to the prevention, assessment, treatment and rehabilitation of musculoskeletal (bone and muscle) injuries.

Our team of surgeons, nurses, physician assistants, rehabilitation specialists and medical support personnel works with each patient?s primary care physician to develop a treatment program specifically for that patient. By combining extensive clinical expertise with a compassionate, caring treatment philosophy, we have created a program known for its quality of care. In addition, the surgeons of Tier 1 Orthopedics practice primarily at Cookeville Regional Medical Center and can call upon board-certified cardiologists, pulmonologists, anesthesiologists, neurologists and other surgical subspecialists to assist in the care of patients.


Referral to Tier 1 Institute from your primary care physician is recommended but not required. Your musculoskeletal system is prone to minor problems that may produce pain, and your family physician may refer you to us to see if surgery is indicated. However, we usually do not treat you for each new episode of pain unless you have been referred to us by your primary physician.

Telephone Calls

Because of schedules and emergencies, it is not possible for our surgeons to answer all calls. Be assured, however, that their answers to your routine questions will be relayed to you by a member of our trained staff. More complicated questions will be answered by your primary physician or by our physician assistant returning your call.

Prescription and Refills

We issue prescriptions and refills during office hours. We do not routinely write or call in prescriptions after hours because our physician on call will not have your medical record in front of him.


We share your concern about the cost of medical care. Our fees are in line with fees for similar services in this area. We are specialists, and our fees may be somewhat higher than the fees of other physicians who do not specialize. Depending on the nature of your problem, you will be charged either one of two ways.

For major injuries and surgery, we charge one fee for all the physician time involved in treating your condition. For most of the less severe problems, we charge a fee for each office visit. Charges for X-rays, injections, crutches, splints and casts are not included in our office visit fees.

Please plan on paying for office services at the time they are rendered unless you have made other arrangements with your doctor in advance. (VISA© and MasterCard© accepted.) Also, please feel free to discuss your bill with us at any time.


We prepare and submit insurance claim forms for your insurance company usually within 10 days of receipt in our office. For insurance forms in addition to ours, a $5 charge is assessed. Too often, health insurance is purchased in the mistaken belief that it always covers medical and hospital costs in full. Some do cover many services in full; others do not.

We invite you to discuss this matter with our insurance secretary, who will freely give you an informed opinion about the coverage you have or are considering, and will, of course, assist you as much as possible to see that you are treated fairly. Insurance aside, we stress that the financial responsibility for payment of services rendered rests with you or your family.


When you visit our office, please advise our receptionist of any changes in your address, telephone number, marital status, insurance status, etc.

Patient Care

In follow-up care, you may be seen by a physician assistant, who is licensed in the State of Tennessee.


Please bring with you any X-rays previously made. Your doctor may wish to consider them in his evaluation of your condition. The law requires that we keep X-rays made at Tier 1 as legal documents, but we will be glad to make you copies at $8 each.