2027 Medicare Changes: What They Could Mean for Orthopaedic Care
Proposed Medicare Changes for 2027 and Orthopaedic Care
Proposed Medicare changes for 2027 have prompted concerns from orthopaedic leaders about how physician payment policies could affect access to care. Dr. Wilford K. Gibson, an orthopaedic surgeon at Atlantic Orthopaedic Specialists (AOS) and president of the American Academy of Orthopaedic Surgeons (AAOS), is speaking about the potential effects on patients and independent medical practices.
In a July 22, 2026, AAOS Now article, Dr. Gibson discussed the proposed Medicare Physician Fee Schedule and the connection between physician reimbursement and patient access.
“CMS cannot continue to erode physician payment year after year and expect patient access to remain intact,” said Dr. Gibson.
He expanded on those concerns in his September 18, 2026, commentary, Protecting independent practices and patients, and in an August 10 interview with Becker’s Spine Review.
What Medicare is proposing for 2027
The Medicare Physician Fee Schedule helps determine how Medicare pays physicians and certain other healthcare professionals for covered services. These payments account for the work and resources involved in providing care.
In its July 14, 2026, proposal, the Centers for Medicare & Medicaid Services (CMS) outlined changes to payment calculations, practice expenses, and reimbursement when certain office visits and procedures occur on the same day. CMS says its approach aims to improve payment accuracy, including addressing payments for overlapping work. Read the CMS proposal summary.
AAOS argues that the proposed payment changes could place additional financial pressure on orthopaedic practices and make it harder for some physicians to continue caring for Medicare patients.
What a second visit could mean for a knee injection
Consider this illustrative example: A patient arranges a ride to an orthopaedic appointment for worsening knee pain. After evaluating the knee, the doctor recommends a cortisone injection that could be given during the same visit, when medically appropriate.
Under the proposed payment policy, if the evaluation qualifies for separate billing alongside the injection, Medicare would pay the higher-valued service in full and reduce payment for the lower-valued service by 50%. This does not mean a 50% reduction in payment for the entire visit.
The American College of Surgeons warns that this could encourage some practices to schedule evaluations and procedures on different days. If a practice changed its scheduling in response, this patient would need to return for the injection. That could mean arranging another ride, waiting longer for the injection, and paying additional transportation or caregiver costs. A family member accompanying the patient might also need to take more time away from work.
Dr. Gibson raised the same concern in his Becker’s interview, describing the costs of injection supplies, medication and staff.
Read the American College of Surgeons explanation of the same-day payment proposal.
Why AAOS is concerned about patient access
According to AAOS, physician practices already face rising operating costs and years of Medicare payment instability. The organization warns that further reductions could affect the availability of orthopaedic care.
AAOS identifies several potential consequences for patients:
- Longer waits for care if practices have less capacity to see Medicare patients.
- Fewer physician choices if more independent practices become part of larger health systems.
- Higher costs in some circumstances as care shifts between practice settings.
These are concerns raised by AAOS about possible effects, rather than confirmed outcomes for individual patients or practices.
“Private practice orthopaedic surgeons are on the front lines of delivering efficient, high-quality care in communities across the country. This proposal threatens that model, accelerates consolidation and makes it harder for surgeons to continue caring for Medicare patients.”
Dr. Wilford K. Gibson, quoted in AAOS Now
Dr Gibson on independent practices and rural access
In his September commentary, Dr. Gibson emphasized that losing an independent practice can have lasting effects on a community. Once a practice is absorbed into a larger health system, rebuilding that local option may be difficult.
“Fewer community-based practices mean fewer choices, longer wait times, and reduced access to care,” Dr. Gibson wrote.
His Becker’s interview focused on what that could mean in rural communities, where patients may have few nearby alternatives. He warned that financial pressure could contribute to office closures, earlier retirements or the sale of independent practices.
“Some practices in rural areas are going to realize it’s just much too risky to stay open,” Dr. Gibson told Becker’s.
He did not estimate how many practices might close if the rule is finalized. His concern was the effect of losing access in communities with limited alternatives.
What AAOS is asking CMS to do
In its July statement, AAOS called on CMS to pause the proposed payment values, retain the 2026 values, and work with physicians on an approach that accounts for the cost and complexity of musculoskeletal care. The organization said it would continue working with CMS, Congress, and the physician community on its concerns.
In his September commentary, Dr. Gibson also described AAOS’s participation in the Same Day Care Coalition. The group is working with CMS, Congress and others to support payment policies that let patients receive a medically necessary evaluation and treatment during one visit. Its priorities include preserving access to coordinated care and ensuring that payment reflects the work involved.
“We will not stand by while these regulations threaten the ability of orthopaedic surgeons to care for the patients who need them,” said Dr. Gibson. “CMS should listen to physicians, listen to patients and pause this rule before it does real harm.”
Let Your Voice Be Heard
Please help preserve the orthopaedic care you know and trust. Share your concerns about the proposed Medicare changes and support continued access to orthopaedic care in our communities.
What patients should know about the proposal
A proposed rule is a step in the federal rulemaking process. Its provisions can change before a final rule is issued. CMS described the proposed 2027 policies as taking effect on or after January 1, 2027, if finalized.
Dr Gibson and orthopaedic care in Hampton Roads
At Atlantic Orthopaedic Specialists, Dr. Gibson is a board-certified orthopaedic surgeon specializing in joint replacement and sports medicine. AOS provides orthopaedic care for patients across Hampton Roads and the surrounding communities, with offices in Virginia Beach, Norfolk, and Chesapeake.
Learn more about Dr. Wilford Gibson and his areas of expertise.
Read the full July AAOS article on the proposed Medicare changes and Dr. Gibson’s comments.
Read Dr. Gibson’s September commentary on protecting independent practices and patients.
