The Centers for Medicare and Medicaid Services (CMS) proposed payment policy changes last month that significantly impact hip and knee surgeons by devaluing procedures by 5.4% work RVUs. Authors of the article, “Substantial Preoperative Work Is Unaccounted for in Total Hip and Knee Arthroplasty,” published in the Journal of Arthroplasty (JOA) in April, prospectively tracked a consecutive series of 438 primary total hip and primary total knee arthroplasty procedures to track preoperative time spent with patients. They found that “surgeons and advanced practice providers spend nearly two hours per arthroplasty patient on preoperative care not accounted for in current RUC methodology.” Log in to JOA to read the study.