The Total Joint Value Calculator, free edition · CY2027 final rules
What does 2027 do to your practice?
Medicare's CY2027 final rules cut what surgeons are paid for a hip or knee replacement and raise what the hospital outpatient department is paid for the same operation. Move the slider to see the size of each change at your volume. Then run the free calculator below with your own numbers, or sign in for your hospital's figures.
Your practice
cases
0200400600800
Run it with your own numbers
Free calculator, no sign-in needed. For your own hospital's figures, sign in with an access code.
Your fees:−$30,993
Hospital:+$192,075
At 150 cases a year, you would lose about $30,993 in Medicare professional fees, while the hospital's outpatient payments for those same cases rise about $192,075. That is $6.20 more for the hospital for every $1 less for you.
| Your professional fees, 2026 | $174,102 |
| Your professional fees, 2027 | $143,109 |
| Change in your fees | −$30,993 (−17.8%) |
| Hospital outpatient payments, 2026 | $1,954,275 |
| Hospital outpatient payments, 2027 | $2,146,350 |
| Change in hospital payments | +$192,075 (+9.8%) |
Typical hospital (middle of the national range), Medicare rates, before payer mix. Hip and knee averaged.
Payments as volume grows
Hospital outpatient payments
Your professional fees
Change versus 2026, per year. The dashed line is the volume you chose.
Surgeon's share
20268.1%
2027 final6.2%
Hospital outpatient payment
Surgeon's professional fee
Hip or knee, hospital outpatient: surgeon fee divided by surgeon fee plus facility fee.
How the numbers are built
| Item | 2026 | 2027 final | Change |
|---|---|---|---|
| Work RVU, hip or knee replacement | 19.11 | 16.70 | −12.6% |
| Total RVU, knee (work, practice expense, malpractice) | 34.71 | 29.21 | −15.8% |
| Total RVU, hip (work, practice expense, malpractice) | 34.79 | 29.27 | −15.9% |
| Conversion factor, most surgeons | $33.40 | $32.63 | −2.3% |
| Professional fee per case, hip and knee averaged | $1,161 | $954 | −17.8% |
| Hospital outpatient payment, per case | 2026 | 2027 final | Change |
|---|---|---|---|
| Low end of the national range | $12,327 | $13,539 | +9.8% |
| Typical hospital (middle of the range) | $13,029 | $14,309 | +9.8% |
| High end of the national range | $13,730 | $15,079 | +9.8% |
The range runs from the 25th to the 75th percentile of U.S. hospitals by wage index. Your own hospital's figure is in the full calculator.
Free edition
Whether to negotiate
National ranges and four views, with no sign-in. Enough to tell you if the conversation is worth having.
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What number to bring
Your hospital's wage index, your payer mix, employed or private practice, block-day scenarios, and a PDF report emailed to you.
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The report you email yourself
A PDF of the full calculator, built from your inputs, to bring to the negotiating table.
Summary
Surgeon share
Scenarios
Your inputs
The Total Joint Value Calculator, free edition
Four national-average views of what your cases are worth, free, with no expiration.