AAOS strongly opposes the Centers for Medicare & Medicaid Services' (CMS) calendar year 2027 Medicare Physician Fee Schedule (MPFS) proposed rule and is calling on CMS to pause implementation of the new proposed payment values, maintain the current 2026 values and work with physicians to develop a more stable and sustainable approach to Medicare physician payment.

CMS is proposing several policies at once that, together, represent one of the most significant threats to independent orthopaedic practice in decades. The combined effect is greater financial instability and increased pressure for physicians to sell their practices to hospitals and large health systems. Policies of concern include: 

• Reducing payment for separate identifiable evaluation and management (E/M) services billed with Modifier-25 on the same day as procedures with 0-, 10-, and 90-day global periods;  
• Reducing relative value units (RVUs) for total shoulder, total hip, and total knee arthroplasty services along with shoulder hemiarthroplasty; and  
• Removing the Indirect Practice Cost Index (IPCI) from the calculation of practice expense RVUs.

AAOS Action Plan At-A-Glance

AAOS is taking coordinated action to oppose harmful Medicare payment cuts and protect access to musculoskeletal care. Current work includes:

• Urging CMS to withdraw or substantially revise the proposed cuts to orthopaedic procedures and Modifier 25 changes. 

• Meeting with CMS, HHS and White House officials to explain the real-world impact on patients, practices and care delivery. 

• Engaging Congress on legislative options to reduce or prevent harmful payment cuts before they take effect. 
• Mobilizing AAOS members through action alerts, advocacy events and direct outreach so policymakers hear directly from orthopaedic surgeons. 
  
  
• Coordinating with specialty societies, physician partners and other stakeholders to align messaging and amplify shared concerns. 
  
  
• Submitting a formal AAOS comment letter to CMS. On September 14, AAOS submitted a comment detailing concerns with the CY27 Medicare Physician Fee Schedule proposed rule. 

Help Push Back Against Medicare Cuts 

AAOS is building a strong, evidence-based case against the proposed cuts by combining policy analysis, member perspectives and real-world examples of how these changes could affect patients, practices and access to care. 

As a result of our ongoing advocacy efforts, Rep. Greg Murphy, MD, of North Carolina has introduced a congressional sign-on letter urging the CMS to halt proposed payment cuts in the fee schedule that would negatively impact musculoskeletal care.

Take action today and ask your Representative to sign on! 

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