What your total joint volume is really worth to the hospital.
This model reconstructs the CMS payment formulas that determine what a hospital collects for every primary hip and knee replacement you do, including DRG, wage index, IME, DSH, and payer mix, so that the facility-side value an employed TJA surgeon generates is visible, not assumed. It was built to bring a rigorous, source-grounded number to the table in wRVU rate discussions, especially as CMS payment policy shifts under CMS-1848P/1850P/1851P.
What it does
Enter a hospital by zip code and name, and the model walks the full CMS payment chain for primary total joint arthroplasty:
- Zip code → county → CBSA/Metro Division → wage index (FY2026 and FY2027, sourced separately from CMS-1833-F and CMS-1849-F)
- Full DRG 469/470 reconstruction, including operating and capital payment, IME, DSH, uncompensated care, and VBP/HRRP adjustments, driven off the CMS IPPS Impact File
- A decomposed facility payer-mix modifier, with adjustable government rate, APM participation bonus, private payer rate, and government weight inputs
- Negotiation-ready output: the facility-side dollar value generated per case, and per year, at your volume
Where the numbers come from
Every figure traces back to a published CMS source: the IPPS and OPPS final rules and NPRMs (CMS-1833-F, CMS-1849-F, CMS-1834-FC, CMS-1850-P, CMS-1851-P), the OPPS Addendum A, the CMS IPPS Impact File, the HUD zip-to-county crosswalk, and the OMB CBSA delineation file. Nothing here is a rule of thumb; every formula and every reference figure resolves to a citable CMS document.
Access the calculator
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