The OrthoForum, American Association of Orthopaedic Surgeons and American Alliance of Orthopaedic Executives urged CMS to reconsider several policies in the CY 2027 Medicare Physician Fee Schedule proposed rule, including arthroplasty payment reductions and a proposed 50% Modifier 25 payment reduction, according to comments submitted to CMS and shared with Becker’s.
The OrthoForum modeled approximately 19.7 million services and estimated Medicare PFS payments would decline from approximately $1.721 billion in 2026 to $1.634 billion in 2027, a reduction of approximately $86.8 million, or 5%. Major arthroplasty services accounted for approximately $58.4 million, or 67.3%, of the modeled reduction.
AAOS, which represents more than 39,000 orthopedic surgeons and residents, urged CMS to maintain CY 2026 work relative value units for shoulder hemiarthroplasty and total shoulder, hip and knee arthroplasty. The group opposed proposed reductions of over 20% in RVUs for the four procedures. CMS estimates orthopedic surgeons would face a 7% reduction in total allowed charges in CY 2027, according to AAOS’ Sept. 14 comment letter.
AAOS and the American Alliance of Orthopaedic Executives also urged CMS to withdraw the proposed 50% payment reduction for separately identifiable same-day office or outpatient evaluation and management and procedural services.
The groups also raised concerns about the Ambulatory Specialty Model and proposed changes involving the Indirect Practice Cost Index. The OrthoForum urged CMS to delay implementation of the model until at least Jan. 1, 2028, while AAOS urged CMS to delay it for at least one year.
AAOS and the American Alliance of Orthopaedic Executives also raised concerns about remote monitoring and changes to the Merit-based Incentive Payment System.
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