CJR-X is coming.
Do you know your episode cost?
CMS just finalized the first nationwide mandatory episode-based payment model for hip, knee, and ankle replacements (July 31, 2026). Most IPPS hospitals. 90-day episodes. No opt-out. Performance year begins January 2028.
SurgeonValue was built for this. Five tools work today and six are designs; the labels below say which. First, check whether you are already in a mandatory model: ASM by NPI, TEAM by hospital CCN. Public CMS data, nothing stored.
Every post-op decision now has a dollar sign.
Under CJR-X, CMS sets a target price for every joint replacement episode. That target covers the procedure plus everything for 90 days after discharge — physical therapy, follow-up visits, imaging, DME, readmissions.
Come in under the target? Your hospital shares in the savings. Come in over? Your hospital absorbs the difference.
Which SNF. How many PT visits. When to see the patient back. These are now financial decisions, not just clinical ones.
What to do now — not in 2027.
18 months from rule to performance year. The hospitals that wait are already late. The work below is what wins the first measurement period.
Know your episode cost
What does a total knee actually cost over 90 days? Most surgeons can't answer. The winners will know before performance year starts.
Audit your billing
RTM 98975–98981, CCM 99490–99491, prolonged services 99417, caregiver training 96202–96203 — every unbilled code is money left on the table that won't help you hit target.
Track post-acute utilization
SNF days, home health visits, ED visits, readmissions — all count against your episode. Understand your referral patterns now or pay for them in 2028.
Collect patient-reported outcomes
PROMIS, HOOS, KOOS at baseline and 90 days. Required under TEAM and almost certainly under CJR-X. Start collecting now or you'll have no data when CMS asks.
SurgeonValue was designed for episode-based payment.
Each card says whether it works today or is still a design. Every output is a draft until the surgeon signs or strikes it.
Wonder Bill
Finds the revenue hiding inside your 90-day episode window.
Episode Cost Tracker
Design, not built yet. Would model episode cost once CMS publishes the 2028 target prices.
Prior Auth Agent
Works today. Drafts the letter so the delay is not on your side.
PROM Collector
Works today as attested PROMs (KOOS-JR demo). Baseline and 90-day collection is the design.
Documentation Agent
Works today as the Coding Audit: shows the sentence behind each code. You sign or strike.
RTM / CCM Enrollment
Design, not built yet. RTM is billed by the employed PT under their own NPI, never inside the surgeon's own global period.
CJR-X roadmap.
18 months to performance year.
See what we'd catch.
Target prices for 2028 are not published yet, so nothing here models your episode cost today. What works now: the ASM check by NPI, the TEAM check by hospital CCN, and Wonder Bill on a de-identified note.
Check your hospital (TEAM) →