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News
CMS's proposed 2027 Medicare Physician Fee Schedule would slash reimbursement for joint replacement surgeries by up to 21%, even as orthopedic surgeons have driven a major shift to same-day outpatient procedures. The AAOS calls these the most significant cuts in 30 years, warning they'll reduce patient access — especially in rural areas. Critics argue the policy penalizes the very progress CMS once championed.
Orthopedic surgeons spent years perfecting same-day joint replacement surgeries — and now Medicare wants to cut their pay for it. The CY 2027 Medicare Physician Fee Schedule proposed rule would reduce work relative value units (RVUs) for total knee arthroplasty (TKA), total hip arthroplasty (THA), total shoulder arthroplasty (TSA), and shoulder hemiarthroplasty by 17–21%. CMS projects a 7% aggregate reduction in allowed charges for orthopedic surgery overall. The American Academy of Orthopaedic Surgeons (AAOS) has called these the largest cuts in 30 years and is urging CMS to withdraw the proposals.
The cuts stem from a "site of service anomaly" flagged by the RUC — since these procedures now happen mostly outpatient, inpatient hospital visit payments were removed from the codes. But critics say CMS went further than recommended, using questionable surgical comparisons to justify deeper reductions. Meanwhile, inflation-adjusted Medicare payments for TKA and THA have already fallen roughly 55% since 2000.
By the Numbers:
Why it matters: These cuts could accelerate surgeon consolidation, reduce access for complex and rural patients, and discourage trainees from entering orthopedics — all while surgeons continue shouldering the full 90-day postoperative burden of joint replacement care.
