2027 Medicare Cuts for Orthopedics: Joint Replacement Pay Could Fall About 20%
This piece was written and published by Phreesia, a company that sells patient intake, payments and engagement software. It is included here for its practical insight. Its inclusion does not mean that Healthcare Growth Strategies, its founder, or his employer endorses, recommends, or has a position on Phreesia or its products. Figures drawn from the vendor’s own customer or platform data have not been independently verified.
The proposed 2027 Medicare physician fee schedule would cut orthopedic surgeons’ pay for joint replacements sharply. Phreesia’s analysis cites OrthoForum’s estimate of roughly a 20% reduction in physician payment for hip and knee replacements. Proposed work RVUs fall 16.6% for total knee (19.11 to 15.94), 19.6% for total hip, 19.0% for total shoulder and 20.8% for shoulder hemiarthroplasty. CMS projects a 7% orthopedic payment cut from RVU changes, plus a 1.68% conversion-factor cut for non-APM clinicians; Phreesia estimates 8-9% combined. A same-day visit-plus-procedure rule would pay the lower-priced service at 50%. The final rule is expected in early November. Phreesia suggests five levers: earlier eligibility and authorization checks, collecting at check-in, less manual admin work, faster refilling of cancellations, and clear post-op documentation.
Orthopedic groups and MSOs heavy in Medicare joint volume should model 2027 physician revenue now, before the final rule lands. Facility payments rise 2.4% while surgeon pay falls, which shifts the economics of ASC ownership and joint ventures.
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How much could 2027 Medicare cuts reduce orthopedic surgeon pay for joint replacements?
OrthoForum, cited by Phreesia, estimates about a 20% cut in Medicare physician payment for hip and knee replacements under the proposed 2027 rule. Proposed work RVUs fall 16.6% for total knee and 19.6% for total hip.
When will the 2027 Medicare cuts take effect?
If finalized, the changes take effect January 1, 2027. CMS’s final rule is expected in early November 2026.
What can orthopedic practices do now?
Phreesia lists five levers: verify coverage and prior authorizations early, collect patient balances at check-in, reduce repetitive admin work, refill canceled appointments faster, and keep clear records of post-operative care.