Terms of Service

The Service is intended for physicians, practice administrators, and other healthcare professionals. You must be at least 18 and able to form a binding contract. If you subscribe on behalf of a practice or institution, you confirm you have authority to bind it.

The Service estimates the financial effects of Medicare payment rules (such as the CY2027 OPPS/ASC and Physician Fee Schedule rules) on hospitals and physicians. Outputs are estimates only. They rely on published CMS data, national averages unless a tool states otherwise, and assumptions you enter. Actual payments depend on many factors we do not model, and CMS rules, rates, and policies change.

The Service is not financial, legal, tax, coding, billing, or compensation advice. Do not rely on it as the sole basis for a contract negotiation, employment decision, or investment. You are responsible for verifying any figure before relying on it and for consulting your own advisors.

Do not enter patient information. The Service does not need, and is not designed to receive, protected health information or any patient-identifying data.

• Accounts: Registration requires accurate information (title, name, and email address) and creates an account. We email a sign-in link to the address you give us. Keep your account to yourself.

• Free access: Anyone who registers with a valid email address gets access to both calculators through December 31, 2026, with no card required. Free access ends automatically on that date. It does not renew, does not extend, and does not convert to a paid plan. It is provided without any guarantee of availability, accuracy, or support. We may change, limit, or suspend free access at any time, and we may suspend any account for abuse or for violating these Terms.

• One named user per account: Accounts and access codes are licensed to one named user and may not be shared, posted, or resold. Institutional licenses cover only the seats stated in your order.

• Access codes: Any access code we issue works only until its stated end date and may be withdrawn.

• Suspension: We may suspend or revoke access for sharing credentials, misuse, or violation of these Terms.

• What you buy: A subscription includes access to the calculator, plus updates we make to it to reflect changes to federal payment rules (for example, CMS proposed and final rules) during your paid term. We will make reasonable efforts to publish such updates promptly after the rules are released, but timing depends on CMS release schedules and we do not guarantee a specific date.

• Prices: An individual subscription is $299 per year or $29 per month. Institutional licenses are priced per seat (see "Institutional licenses" below). Prices are in US dollars.

• Founding rate: An annual subscription purchased by 11:59 p.m. Eastern Time on December 31, 2026 is $200 for the first year only. It then renews automatically at the standard annual price (currently $299) unless you cancel. The renewal price is shown at checkout, in your welcome email, and in your renewal reminder.

• Subscribing before January 1, 2027: If you subscribe before January 1, 2027, your access starts immediately and your card is not charged until January 1, 2027. If you subscribe on December 30 or 31, 2026, our payment processor requires a short delay, so your first charge will occur on the date shown at checkout, which will be between January 1 and January 3, 2027. If you cancel before your first charge, you will not be charged.

• Subscribing on or after January 1, 2027: Your card is charged at checkout.

• Automatic renewal: Subscriptions renew automatically at the end of each billing period (monthly or annually, as you chose) at the then-current price until you cancel. By subscribing you authorize us, through our payment processor (Stripe), to charge your payment method on each renewal.

• Reminders: Your welcome email states your first charge date and how to cancel. For annual plans we will email you about 30 days before each renewal, stating the renewal date, the price, and how to cancel. For monthly plans, we will email you once a year to say that your subscription renews monthly, the monthly price, and how to cancel. If more than 31 days will pass between your sign-up and your first charge, we will also email you shortly before that charge.

• How to cancel: You can cancel at any time online from your account page, in the same way you subscribed, with no need to contact us. Cancellation takes effect at the end of the current paid period, and you keep access until then. If you cancel before your first charge, nothing is charged.

• Refunds: Monthly plans and renewals are non-refundable. For an annual plan, you may request a full refund within 14 days of your first charge (the window runs from the first charge, not from sign-up). Because renewals are not refundable, please cancel before the renewal date if you do not want to renew. Nothing here limits refund rights you have under applicable law.

• Price changes: We will give at least 30 days' notice by email before any price increase takes effect for your subscription, and you may cancel before it does.

• Taxes: Prices do not include sales, use, or similar taxes. If tax applies to your purchase, we calculate it from your billing address and the location where you use the Service, and we add it at checkout and on each renewal. If you are exempt, send us a valid exemption certificate before your purchase or renewal.

• Record of your agreement: When you subscribe, we record the time, your IP address, the version of these Terms, your plan, and the exact statement you accepted, and we keep that record as evidence of your authorization.

• Failed payments: If a payment fails we may retry and may suspend paid access until it is resolved.

• Institutional licenses: Institutional licenses are sold by written order form, are annual, and are priced per seat, with a minimum annual fee for each tier. A "seat" is one named user, and surgeons and administrative users each count as a seat. Your annual fee is the greater of (seats multiplied by the price per seat) and the annual minimum for your tier. Systems with 51 or more seats are priced by written quote, starting at the rate shown. If the number of seats you use grows beyond the number you purchased, you may keep using the Service, and your fees will be adjusted to your then-current seat count and tier at your next renewal. We may reasonably ask you to confirm your current seat count. Institutional licenses renew annually under the renewal and cancellation terms above, and the order form controls if it conflicts with these Terms.

We own the Service, including the calculators, models, formulas, underlying workbooks, methodology, text, and design, and they are protected by copyright and trade secret law. We grant you a limited, non-exclusive, non-transferable, revocable license to use the Service for your own professional, non-commercial decision-making.

You may not: copy, scrape, or extract the Service's data or logic; reverse engineer or attempt to access source code or models; build a competing product from it; resell, sublicense, or publicly redistribute the Service or its outputs as a product of your own; or bypass access controls. Reports generated for you may be shared with your own employer, advisors, and counterparties in the ordinary course of your decision-making, with attribution to the Service.

You keep ownership of the inputs you enter. You grant us permission to process them to operate the Service as described in our Privacy Policy.

The Service is an independent product of Cutler Court Associates, LLC. It is not sponsored, endorsed, or operated by the American Academy of Orthopaedic Surgeons (AAOS), the American Medical Association (AMA), the Centers for Medicare & Medicaid Services (CMS), or any hospital or health system. Opinions and analyses in the Service are our own and do not represent the positions of any of those organizations. CPT® is a registered trademark of the American Medical Association.

THE SERVICE IS PROVIDED "AS IS" AND "AS AVAILABLE." TO THE FULLEST EXTENT PERMITTED BY LAW, WE DISCLAIM ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING ACCURACY, COMPLETENESS, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT. WE DO NOT WARRANT THAT OUTPUTS WILL MATCH ACTUAL PAYMENTS OR THAT THE SERVICE WILL BE UNINTERRUPTED OR ERROR-FREE.

TO THE FULLEST EXTENT PERMITTED BY LAW, WE ARE NOT LIABLE FOR INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, OR FOR LOST INCOME, LOST CONTRACT TERMS, OR LOST OPPORTUNITIES ARISING FROM YOUR USE OF OR RELIANCE ON THE SERVICE. OUR TOTAL LIABILITY FOR ANY CLAIM IS LIMITED TO THE GREATER OF THE AMOUNT YOU PAID US FOR THE SERVICE IN THE 12 MONTHS BEFORE THE CLAIM AND $100. Some jurisdictions do not allow certain limitations, so some of these may not apply to you.

You may stop using the Service or cancel at any time. We may suspend or terminate access for violation of these Terms. Sections on intellectual property, disclaimers, limitation of liability, and governing law survive termination.

These Terms are governed by the laws of the State of Rhode Island, without regard to conflict-of-law rules. Any dispute that is not resolved informally will be brought exclusively in the state or federal courts located in Rhode Island, and you consent to their jurisdiction. Before filing a claim, you agree to contact us at the address below and give us 30 days to try to resolve it informally.

We may update these Terms. We will post the new date and, for material changes affecting paid subscribers, email you before they take effect. Continued use after the effective date means you accept the changes.

Cutler Court Associates, LLC
PO Box 4472
Middletown, RI 02842
support@cutlercourt.com