Contract intelligence
Structure payer products, fee schedules, Medicare tiebacks, and effective dates in one usable model.
Practice financial intelligence
Fulcrum for Orthopedic Surgery.
See how every contract, payment, and service line performs. Bring surgery, imaging, injections, therapy, and ancillary revenue into one contract and service-line view.
Financial visibility for Orthopedic Surgery
Orthopedic economics are split across procedures, sites of care, and ancillary services.
Fulcrum connects reimbursement terms to actual volume across surgery, office procedures, imaging, and therapy so leaders can compare payer performance and service-line economics in one place.
One connected intelligence layer
Built for the questions your finance team actually has.
Payment monitoring
Detect and investigate potential underpayments in an automated, accurate way.
Forecasts & negotiations
Test proposed rates against actual volume and bring clear evidence into payer conversations.
Service-line economics
Integrate encounter and cost data to see precise unit economics for specific CPT codes.
What becomes answerable
Move from reported revenue to financial context.
- 01Which payer products are underperforming?
- 02Which payments do not match the contract?
- 03How will a proposed rate change affect revenue?
- 04Which services produce the strongest unit economics?
CY 2027 proposed PFS
What the proposed rule could mean for Orthopedic Surgery.
A national specialty average is useful context, not a practice forecast. Your result depends on your codes, volume, locality, sites of service, and Medicare-linked contracts.
-5.8%CMS specialty estimate
CMS's projected overall impact for Orthopedic Surgery
CMS's own reconciliation table (Table D-B5) puts orthopedic surgery at -5.8% for 2027. That figure is the specialty-wide, volume-weighted change in total RVU-based allowed charges: the aggregate gain or loss across every code the specialty bills, before the separate conversion-factor cut.
Orthopedic Surgery bills about 47% of its Medicare dollars in the office (non-facility) setting. By site of service, the 2027 change splits as follows:
| Site of service | Change | Allowed $ |
|---|---|---|
| Office (non-facility) | -5.8% | -$90M |
| Facility | -8.9% | -$155M |
All figures are national, hold 2025 utilization fixed, and exclude the separate 1.68* conversion factor cut.
The average hides the practice-level spread.
How Fulcrum models the PFS →
The specialty average hides a wide spread, and CMS's own practitioner-level file proves it. 30% of orthopedic surgery practitioners land in the -10 to -5% band, and about 57% see a cut deeper than 2%. Where a practice lands is a question of service mix: the orthopedic surgery practices hit hardest are those with the heaviest major-joint arthroplasty volume; the office injection-and-visit practices move far less.
Practice-specific analysis
See what your contracts and service mix say.
Start with one contract, one fee-schedule question, or an ongoing view across the practice.