AAOS Objects to Proposed CMS 2027 Medicare Physician Fee Schedule

The American Association of Orthopaedic Surgeons (AAOS) opposes the Centers for Medicare & Medicaid Services’ (CMS) calendar year 2027 Medicare Physician Fee Schedule (PFS) proposed rule and is urging the agency to withdraw the proposed policies, claiming they threaten patient access to high-quality musculoskeletal care.

AAOS wants 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.

At a time when Medicare enrollment has surged to more than 70 million, beneficiaries need more access to musculoskeletal care, not less, according to AAOS. CMS’ proposed rule places additional strain on physician practices already struggling with rising practice costs and years of Medicare payment instability, the organization charges. Orthopedic surgeons remain committed to delivering efficient, high-quality care, but physician practices cannot absorb significant reimbursement cuts year after year without consequences for patient access.

Orthopedic surgeons, as well as a handful of other specialties, are the last frontier of independent medical practice. CMS’ proposed rule threatens to push these specialties over the tipping point, AAOS alleges. After years of payment cuts to Medicare physician services generally, this rule would cause irreparable damage by instituting acute cuts to orthopedic care that will change the face of American health care indefinitely, AAOS argues.

“CMS cannot continue to erode physician payment year after year and expect patient access to remain intact,” AAOS President Wilford K. Gibson, M.D., said. “Private practice orthopedic surgeons are on the front lines of delivering efficient, high-quality care in communities across the country. This proposal threatens that model, accelerates consolidation and makes it harder for surgeons to continue caring for Medicare patients. AAOS is calling on CMS to press pause, maintain the 2026 values, and work with physicians on a policy that reflects the true cost and complexity of musculoskeletal care.”

AAOS is particularly concerned about the cumulative impact of ongoing physician payment reductions. Orthopedics remains one of the last major physician specialties in which independent practice is viable. As care shifts from independent physician practices to larger health systems, patients often face higher costs, fewer choices, and longer wait times. This proposal would accelerate consolidation into large health systems and permanently reshape how musculoskeletal care is delivered.

Orthopedic surgeons provide care that restores mobility, relieves pain, and helps patients maintain their independence and quality of life. Medicare Physician Fee Schedule should support those outcomes by preserving patient access, rewarding efficiency, and allowing physicians to make treatment decisions based on clinical expertise and the needs of individual patients, not administrative assumptions, AAOS asserts.

“This is not just a payment issue. It is a patient care issue,” AAOS Advocacy Council Chair Joel L. Mayerson, M.D., stated. “The Proposed Rule undervalues the work required to diagnose, treat, and manage complex musculoskeletal conditions, resulting in fewer physician options, longer wait times, and delayed access to care for Medicare beneficiaries. Clinical judgment must drive care decisions, not administrative policy that fails to account for what patients and surgeons face in the exam room and operating room.”

AAOS will continue working with CMS, U.S. Congress, and the broader physician community to prevent these policies from being implemented.

“We will not stand by while these regulations threaten the ability of orthopedic surgeons to care for the patients who need them,” Dr. Gibson said. “CMS should listen to physicians, listen to patients, and pause this rule before it does real harm.”

With more than 39,000 members, AAOS is the world’s largest medical association of musculoskeletal specialists. The organization advances musculoskeletal health by providing comprehensive education to help orthopedic surgeons and allied health professionals best treat patients in their daily practices. AAOS is the source for information on bone and joint conditions, treatments, and related musculoskeletal healthcare issues; and it leads the healthcare discussion on advancing quality.