On November 4, 2026, the Centers for Medicare & Medicaid Services' (CMS) released the calendar year 2027 Medicare Physician Fee Schedule (MPFS) final rule. 

CMS originally proposed several policies at once that, together, represented one of the most significant threats to independent orthopaedic practice in decades. As a result of ongoing advocacy from orthopaedic surgeons, the final rule included the following adjustments: 

Approximately 10% cut to Total Joint Codes 

Cuts to relative value units (RVUs) for total hip, total knee, total shoulder arthroplasty, and shoulder hemiarthroplasty were reduced by roughly 50% compared to the proposed rule. 

Modifier 25 Policy 

A 20% cut to the lesser of two E/M services billed with Modifier-25 on the same day as procedures with 0- day global periods. This is a positive shift from the proposed rule, which included a 50% cut for procedures with 0-, 10-, and 90-day global periods. 

Join the Fight 

Physicians need predictable, sustainable payment updates that reflect the cost of delivering care. Although CMS made some adjustments that reduce the impact of its initial proposal, the final rule falls short of our recommendations and does not resolve the underlying challenges facing orthopaedic practices

AAOS remains committed to advocating for sustainable payment policies that support orthopaedic surgeons and preserve access to high quality musculoskeletal care. We will keep working with Congress on permanent solutions that account for medical inflation and appropriately value physician services.

As we continue the fight, your story can help illustrate the real-world impact of these policies to lawmakers.

Record a short video today! 

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