As previously reported, the Centers for Medicare & Medicaid Services (CMS) recently identified seven high volume current procedural terminology (CPT) codes as potentially misvalued, among which were 27130 (total hip arthroplasty) and 27447 (total knee arthroplasty), in the 2019 Medicare Physician Fee Schedule Final Rule. CMS requested Relative Value Update Committee (RUC) of the American Medical Association (AMA) re-evaluate the work for these procedures. As we develop a strategy to address this issue, we continue to work with the American Academy of Orthopaedic Surgeons (AAOS) and other specialty societies whose codes were flagged as potentially misvalued.
In addition, AAHKS and AAOS met with CMS staff to discuss the issue and emphasize our active engagement with CMS on value-based payment reform, the success surgeons have achieved in reducing the overall cost of hip and knee replacement and how undervaluing services may impact patient access. We will continue to keep these communication channels open with CMS staff.
AAHKS and AAOS leaders and staff meet every two weeks to discuss the issue. Staff from both societies have met twice with the other groups representing the five other potentially misvalued codes as well as meeting with the AMA RUC staff for guidance and to discuss ways forward.
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Finally, our Orthopaedic PAC is important to this issue. Please contribute by texting AAHKS to 4144 or click here to donate.