Look up any hospital's CJR-X exposure.

Anchor spend = Σ DRG discharges × average Medicare payment (inpatient) + APC 5115 services × average Medicare payment (outpatient). Medicare fee-for-service only; counts under 11 are suppressed by CMS.

The 1.73 multiplier is 1 ÷ 0.578: the anchor stay was 57.8% of Medicare spending on an elective 90-day joint-replacement episode at CJR hospitals in 2021–2024 (Lewin for CMS, CJR final evaluation appendices, Exhibit D-6; see the chart above). v5 of this engine used 1.65 (60%); every dollar figure on this page was recomputed with 1.73 on Sep 26, 2026. It is a national average for elective cases; hip-fracture episodes run heavier (all LEJR: ×1.98), and a hospital that uses more skilled nursing will run higher.

Readmission penalty (HRRP). CMS's FY 2027 supplemental file gives every hospital's payment adjustment factor (0.97–1.0) and the percentage it cuts from Medicare base operating DRG payments for discharges from Oct 1, 2026, built from six measures, one of them elective hip/knee replacement. A measure counts only when the hospital's excess readmission ratio is above the median of its peer group (five groups by dual-eligible share) with at least 25 eligible discharges; the hip/knee penalty flag shown here is that test. The dollar figure is ours, not CMS's: the reduction applies to base operating DRG payments (no IME, DSH, outliers or add-ons), which we reconstruct from the FY 2027 Impact File as standardized amount × transfer-adjusted cases × transfer-adjusted case-mix index, using the FY 2025 MedPAR cases the Impact File carries. Hospitals not in the FY 2027 files keep their FY 2026 values, labelled by year.

PRO-PM penalty. A hospital that fails Hospital IQR reporting, including the hip/knee PRO-PM (≥50% of eligible elective cases with matched pre- and post-op surveys; 91 FR 50158), has its annual IPPS update cut by one quarter of the market basket (Social Security Act § 1886(b)(3)(B)(viii); 91 FR 49835). The FY 2027 market basket is 3.2% (91 FR 49837), so the cut is 0.8 percentage points, applied to the operating standardized amount and therefore to every Medicare inpatient stay, not only joint replacements. Mandatory PRO-PM reporting began with the July 1, 2025–June 30, 2026 period, which counts for the FY 2028 payment determination (87 FR 49280). The cut applies to the year involved and recurs every year reporting is missed. The base is each hospital's FY 2026 operating IPPS revenue rebuilt from the FY 2026 IPPS Impact File (transfer-adjusted Medicare cases × case-mix index × operating federal rate per unit weight, including IME/DSH; capital, outliers and uncompensated-care payments excluded). The FY 2028 market basket is not yet published; 3.2% is the latest final value. Maryland hospitals are not modeled.

Quality score (0–20), estimated. Each public measure is converted to a national percentile, then to points with the rule's tables (§ 512.635(c)); PRO-PM is not public, so every hospital gets the 50th-percentile points, as CMS does for missing measures. The inpatient and outpatient composites are weighted by the hospital's inpatient/outpatient episode mix. Tier cut-points are § 512.645(h).

In scope. "Clears the volume floor" = CJR-X eligible and ≥11 episodes in the public year, which projects to ≥31 over a three-year baseline. "≥31 in one year" is the conservative read.

Model status. CJR-X = CCN on CMS's official participant list (file cjrx-participantlist_10_5_26.xlsx, roster as of Sept 30, 2026: 2,217 hospitals satisfying the 42 CFR 512.605 participant definition; CMS says it will update the list regularly for new hospitals, mergers and closures). TEAM = CCN on the CMS TEAM list. Maryland = state is MD. "Not on list" = scored here (public Medicare hip/knee volume) but absent from the roster — usually a hospital not paid under both IPPS and OPPS, an excluded type, or a closure. The roster replaced this engine's scope estimate on Oct 5, 2026; the estimate had agreed with the list on all but 239 of 2,663 hospitals (45 estimated in scope but not listed, 194 listed but not estimated).

• Volumes are Medicare fee-for-service only and one year (2023). Medicare Advantage, commercial and suppressed counts are missing, so small hospitals look smaller than they are.
• The CJR-X baseline is three years; we project from one.
• Target prices are regional and risk-adjusted by 29 factors; we compare to spend, not a real target.
• Quality percentiles run across all hospitals reporting each measure, not CMS's IPPS-only denominator, and the measure periods predate PY1.
• Safety-net status is proxied by the hospital-wide dual-eligible share ranked within Census division; the rule uses the dual share of LEJR episodes, which is not public. Rural uses the Impact File's geographic flag.
• 59 TEAM hospitals have no public hip/knee volume and are not scored; 7 of them are placed on the map using Price Atlas coordinates.
• CMS publishes TEAM participation but not each hospital's track.
• HRRP dollar figures apply CMS's FY 2027 reduction percentage to a reconstructed base; the actual reduction depends on FY 2027 claims. The Impact File's own proxy readmission factor is preliminary and differs from Table 15 for most hospitals, so Table 15 (the supplemental file) is used.
• The operating revenue base moved from the FY 2026 to the FY 2027 Impact File on Oct 14, 2026 (FY 2027 applies the reduced standardized amounts to the 128 hospitals flagged for an IQR or EHR reduction; the FY 2026 build had used full-update rates for all). The Founding IPPS pricer still prices DRGs at FY 2026 rates until the member data service is refreshed.

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