Medicare’s 2027 joint replacement cuts: approximately 18% less for surgeons

CMS released its 2027 physician fee schedule final rule on November 4. Its selected-procedures table shows national professional payments for total hip and knee replacement falling by approximately 18% compared with 2026.

These are CMS’s national physician-payment examples for services in a facility, using the non-qualifying APM conversion factors. They are not hospital or ASC facility fees, local contracted rates or a forecast of your collections. Download the final CMS table.

Start with your own case mix

Pull your Medicare hip and knee volumes, locality-specific allowances and payer contracts. Separate traditional Medicare from contracts that use a Medicare-based formula. A national headline cannot tell you which contracts reset, when they reset or what your actual exposure will be.

Then examine the work around each episode. Where do unanswered patient messages accumulate? Who reconciles monitoring activity? How much clinical time goes into rebuilding documentation for billing? Identify specific steps before buying another tool or assigning another task to your staff.

The same rule also changes remote monitoring

CMS finalized established-patient and separately reportable initiating-visit requirements for RTM beginning in 2027. The restriction on contractor-delivered RPM/RTM clinical staffing is delayed until January 1, 2029. Practices should review their enrollment and staffing workflows against the final rule before expanding a program. Read CMS’s final-rule summary.

Where BoneArc fits

BoneArc brings patient activity, clinical work and billing preparation into one RTM workflow. Knobby helps organize that work so clinicians can review it and approve what moves toward billing.

A useful evaluation starts with one patient’s path through your practice: enrollment, monitoring, clinical review, documentation and claim preparation. Ask us to walk through that path with your team. You should be able to see what happens, who owns each step and where your existing billing process fits.

RTM requires appropriate care, eligibility and documentation. Do not assume routine postoperative work inside a surgical global period creates a separately payable service, or that RTM revenue will offset a surgical payment cut.

See BoneArc’s RTM workflow and meet Knobby →

Sources and related reading

• CMS-1848-F: final rule and supporting payment tables · displayed November 4, 2026; retrieved November 5, 2026.
• RTM and the global surgical period
• RTM billing requirements