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Total joint arthroplasty is associated with high patient satisfaction and functional improvement. With approximately 400,000 Medicare beneficiaries undergoing the procedure annually, total joint arthroplasty represents the largest total cost of all surgical procedures in the U.S. Centers for Medicare & Medicaid Services (CMS) budget1-3. This has resulted in vigorous efforts by the CMS to control costs without negatively affecting outcomes. Alternative payment methods, such as bundling, allow the CMS to control costs by reimbursing for value rather than volume. The Comprehensive Care for Joint Replacement (CJR) program for a 90-day bundled payment represents CMS’s most recent alternative payment method designed to accomplish this cost-containment goal

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