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Are You Paid by wRVUs?

How the CMS 鈥淓fficiency Adjustment鈥� Will Cut Surgeons鈥� Pay

The Centers for Medicare & Medicaid Services (CMS) has finalized a 2.5% cut to work relative value units (wRVUs) for almost all non-time-based codes starting on January 1, with additional reductions expected every 3 years indefinitely.

This so-called 鈥渆fficiency adjustment鈥� is based on unsupported assumptions about productivity gains, further reducing surgeon reimbursement, and having far-reaching consequences for patients.

Flawed Thinking

CMS claims that surgeons have become more efficient over time, performing procedures faster and with less intensity. However, recent data contradict this assumption.

础听, analyzing more than 1.7 million operations across 249 CPT codes and 11 surgical specialties, found that 90% of procedures took the same or longer to perform in 2023 compared to 2019. All measures of complexity also increased during this time period. In fact, operative times increased by an average of 3.1%.

Inconsistent Implementation

CMS鈥檚 cut even applies to codes that have been recently revalued, despite them not having historical data on efficiency. This logic is flawed and inconsistent.

Unintended Consequences

Reducing wRVUs will have wideranging consequences for surgeons and patients. Many physician compensation models are tied to work or total RVUs, therefore, CMS is directly cutting pay without reducing workload. Physicians locked into multiyear employment agreements could face untenable financial strain, undermining stability in medical practices.

In addition, these cuts could limit access to surgical care, particularly among the sickest or most complex patients.

Call to Action

CMS鈥檚 across-the-board reduction in work RVUs, without clear, data-driven justification, is flawed and harmful.

Congress needs to act swiftly to prevent implementation of this misguided policy before it takes effect on January 1.

Help us fight back against these cuts. Amplify our voice using .

Additional Resources

How the CMS 鈥淓fficiency Adjustment鈥� Will Cut Surgeons鈥� Pay Flyer

Efficiency Adjustment Letter to Congress (November 3, 2025)

CY 2026 Medicare Physician Fee Comment Letter (September 2025)