The OrthoForum projects that its 162 member practices could lose approximately $82 million annually under CMS’ final 2027 Medicare Physician Fee Schedule.
The reductions average approximately $506,000 per practice. The analysis estimates a 5.3% decline in overall Medicare payments, including a 10.1% reduction for surgical services, according to a Nov. 9 news release shared with Becker’s.
Orthopedic and hand surgeons at member practices face a combined 7.1% reduction in Medicare professional reimbursement. Professional reimbursement for total hip, knee and shoulder replacements is expected to fall approximately 18%, following reductions in 2026.
CMS adopted the physician work values recommended by the American Medical Association/Specialty Society RVS Update Committee for major joint replacement procedures rather than the lower values initially proposed. The agency also revised its proposed reductions for separately identifiable evaluation and management services billed with Modifier 25. However, The OrthoForum said the changes would not offset the broader reimbursement cuts.
The organization warned that declining payments could make it harder for independent practices to recruit physicians, retain staff, invest in new technology and expand services. It called on Congress to address the 2027 reductions, establish a permanent inflation-based Medicare physician payment update and reform budget-neutrality requirements that can impose substantial reductions on individual specialties.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
