The Surgeon Is the Cheapest Line on Your Knee Replacement
The person who cuts into your knee collects less every year. The room it happens in collects more.
By Medicare’s math, the most replaceable person in your knee replacement is the surgeon.
Seven straight years of cuts to the fee.
Zero to the room.
The math is the message.
IN TODAY’S ARTICLE:
The total knee professional fee fell from $1,413 in 2020 to a proposed $922 in 2027.
Facility payments rose over the same years, while the physician fee had no inflation adjustment.
CMS set the surgeon’s work below the number the AMA’s own committee recommended.
Surgeons moved these cases to cheaper settings, then absorbed the cost of doing so.
Glossary at the bottom of today’s article.
A surgeon spends a decade in training to replace a knee. Nine years of it after college. Then the operation, then ninety days of follow-up care that Medicare folds into a single fee.
Medicare proposes to pay that surgeon $922 for all of it in 2027.
The building where the surgery happens collects more than $13,000 for the same case.
The surgeon’s number has fallen almost every year since 2020.
The building’s number has gone up almost every year since 2020.
That is the whole story.
Everything below is the receipts.
THE NUMBER THEY WANT YOU TO ARGUE ABOUT
You may have seen the figure $550 circulating. A surgeon posted it. The hospital lobby will tell you it is wrong, and on a technicality, they are right. So let us settle it before it becomes a distraction.
The full Medicare professional fee for a total knee replacement, code 27447, is $922 under the 2027 proposal. The $550 is a smaller number living inside that one. It is the physician-work portion of the fee, about $523 on its own, or roughly what a practice keeps after paying the 40 percent overhead that Medicare pretends to cover. Both math paths land near $550.
So the surgeon is telling you what lands in the practice. CMS is quoting the number before the lights and staff, and the malpractice premium comes out of it. Both numbers are real. The gap between them is the first thing worth noticing. The second is that the $922 gross has been shrinking for years.
You think the US Government will act morally.
Health systems just pay to get their way.
CMS cut you anyway.
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