Patient satisfaction in the service quality of orthopedic hospitals is considered as a prospective performance criterion in evaluating the medical services of a healthcare system. In this research, the most critical and crucial risk factors in service quality are identified by using relevant literature survey and inputs from hospital experts, these factors are tough to control. To solve this issue, the combined risk-based decision-making method for identifying and ranking the risk factors regarding service quality performance is proposed. The objective of this paper is to recognize the best one between five orthopedic hospitals in the service quality performance by using Interval-Valued Fuzzy Modified (IVFM) TOPSIS. Here, a contextual case is conducted in five south Indian orthopedic hospitals for verifying the efficiency of the suggested framework. To arrive at the best decision, Interval-valued fuzzy set theory is used in the IVFM TOPSIS for controlling subjectivity and ambiguity in fuzzy risk scores. The outcomes will help hospital managers implementing the performances of service quality. © 2021, The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.