Has anyone on your billing team, your practice manager, or your specialty society actually told you the real number behind this year's Medicare cut? Not the 2.5% headline. What it works out to on your two highest-volume procedures.

In this episode, Jared breaks down CMS's CY2026 "Efficiency Adjustment," a 2.5% reduction to intraservice time work RVUs that explicitly exempts time-based care (office visits, care management, behavioral health, telehealth) and, by that same design, falls disproportionately on procedural and surgical work. For two of the highest-volume codes in orthopedics, total hip and total knee arthroplasty, CMS's own published figures show an overall reduction of 7.3% to 7.8%, well above the headline number.

Jared walks through what that actually costs a high-volume joint replacement practice in real dollars, using an illustrative planning range rather than a false-precision figure, and lays out three structural moves worth making regardless of politics: reviewing payer mix intentionally, accounting for Medicare-benchmarked commercial contracts, and re-running retirement plan funding projections before this year's numbers surprise you in Q4.