2027 Practice Impact Calculator — Techy Surgeon (Subscribers)

Joint replacement volumes

Annual Medicare FFS cases billed under each code.

Shoulder hemiarthroplasty · CPT 23470 Total shoulder arthroplasty · CPT 23472 Total hip arthroplasty · CPT 27130 Total knee arthroplasty · CPT 27447 Conversion factor

Practice-level scenario

Optional. Applies CMS' specialty-average RVU impact estimates to your book.

Total annual Medicare PFS allowed charges ($) Setting mix for the specialty estimate

Modifier 25 exposure

Same-day E/M visits billed with 0-, 10-, or 90-day global procedures.

Annual same-day E/M visits with modifier 25 Average Medicare allowed per E/M visit ($)

Estimated impact

$0Joint replacement work-component change (proposed wRVU × proposed CF vs. current)

$0Modifier 25 revenue at risk (50% reduction applied to same-day E/M)

$0Specialty-average scenario on total allowed charges

How to read this. The joint replacement figures isolate the work-RVU component only: current work RVU × 2026 conversion factor versus proposed work RVU × proposed 2027 conversion factor, at national rates without geographic adjustment. Total allowed amounts also include practice-expense and malpractice RVUs, which CMS proposes to change separately; the specialty-average scenario (−7% all settings, −5% non-facility, −8% facility) is CMS' own aggregate estimate for orthopedic surgery and overlaps with the code-level math, so do not add the two lines together. The modifier 25 estimate assumes every same-day E/M would take the 50% reduction and that the E/M is never the highest-paid service on the claim. All values from the CY 2027 proposed rule (CMS-1848-P) and may change in the final rule. Directional planning tool, not a payment quote and not reimbursement advice.

Values used. Work RVUs current → proposed: 23470 17.44→13.81 · 23472 21.58→17.49 · 27130 19.11→15.37 · 27447 19.11→15.94. Conversion factors: 2026 QP $33.5675 / non-QP $33.4009 → 2027 proposed QP $33.1693 / non-QP $32.8409.