Challenging the Medicare Physician Fee Schedule (MPFS) Proposed Rule

This episode may include content about the American Association of Orthopaedic Surgeons, its advocacy efforts, and the Political Action Committee of the American Association of Orthopaedic Surgeons (OrthoPAC).

In this episode of the AAOS Now Podcast, host Doug Lundy, MD, MBA, FAAOS, sits down with Joel Mayerson, MD, FAAOS, Chair of the AAOS Advocacy Council to discuss the calendar year 2027 Medicare Physician Fee Schedule (MPFS) proposed rule, which AAOS considers one of the most significant threats to orthopaedic practice in decades.

Dr. Mayerson explains why this moment is different from past fee schedule fights. He walks through the specific provisions driving AAOS’ concern, starting with the proposed 20 percent reduction in valuation for major arthroplasty codes, including total knee, total hip, and total shoulder arthroplasty, as well as shoulder hemiarthroplasty. He also details a proposed change to the Modifier 25 payment policy that would reduce reimbursement when an evaluation and management service and a procedure happen on the same day. This is followed by a discussion of proposed changes to practice expense RVU calculations.

Throughout the episode, Dr. Mayerson emphasizes that these policies will have devastating real-world consequences not only on orthopaedic surgeons, but on the patients they are committed to serving. He explains how independent and rural practices that aren’t able to absorb the additional costs will either close or be consolidated into large systems, leaving fewer options for patients; how Medicare beneficiaries could face longer waits and reduced access to care; and how without timely access to care, simple problems will progress to chronic or debilitating problems, leading to more ER visits and hospitalizations.

Rather than negotiating quietly behind the scenes, Dr. Mayerson explains that AAOS is taking a firm public stance: The Academy is calling for a full pause on the proposed cuts and a return to 2026 payment values while a more collaborative, data-driven solution is developed.

The episode closes with a call to action. Dr. Mayerson urges every AAOS member to get involved, whether through the AAOS Advocacy Action Center, participation in OrthoPAC, or engagement with their state and specialty societies. As Dr. Mayerson emphasizes, advocacy is an extension of patient care. Every letter, comment, and conversation with a legislator helps protect the house of orthopaedics and ensure access to musculoskeletal care for patients across the country.

Host: Doug Lundy, MD, MBA, FAAOS, Deputy Editor, AAOS Now, and Chair, AAOS Now Podcast Workgroup

Guest: Joel Mayerson, MD, FAAOS, Chair, AAOS Advocacy Council; Professor of orthopaedic surgery, Associate Chief Medical Officer, and Medical Director of Perioperative Services and Sarcoma Services, The Arthur G. James Cancer Hospital ("The James") at The Ohio State University Wexner Medical Center; Director, Division of Musculoskeletal Oncology, The Ohio State University Department of Orthopaedics