Published 7/28/2026
At a Glance
- Protecting orthopaedic reimbursement.
- Influencing CPT and Medicare payment.
- Connecting members to coding expertise.
Estimated read time: 3 minutes
Have you ever wondered who makes payment recommendations to insurers and other payers for the procedures you perform every day? How is payment determined for your services? Or how procedures are turned into Current Procedural Terminology (CPT) codes? AAOS has a committee dedicated to addressing these issues and more: the Coding Coverage & Reimbursement Committee (CCRC).
The CCRC’s purpose
The CCRC was established to represent the interests of orthopaedic surgeons on coding and physician payment issues. The committee manages proposals for new and revised orthopaedic CPT codes as well as proposed Medicare relative value units (RVUs) for orthopaedic codes. The committee also provides input to the American Medical Association (AMA), the Centers for Medicare & Medicaid Services (CMS), and private payers on miscellaneous coding and payment policy issues and activities. Additionally, CCRC helps educate orthopaedists on coding and payment issues through educational coding courses, online resources, and coding Q&A services.
The CCRC’s composition
The CCRC is composed of 12 assigned seats for musculoskeletal specialty society representatives from the AAOS Board of Councilors (BOC) and AAOS Advisors to the AMA CPT Editorial Panel and AMA Relative Value Scale Update Committee (RUC). In recent years, seats have been added for a candidate member as well as a member-at-large. Many of the members serve as advisors to AMA CPT or RUC or their subspecialty society and have held those positions for several years. This arrangement ensures the CCRC brings a high level of historical knowledge and expertise to the table when navigating payment and coding processes.
“The members of the CCRC feel a deep obligation to the members of AAOS to present the complexity of the work performed by orthopaedic surgeons to the AMA, government, and insurance organizations,” said CCRC Chair John P. Heiner, MD, FAAOS. “The committee’s work directly impacts payment for procedures surgeons to ensure they are getting fair reimbursement for their efforts in caring for orthopaedic patients.”
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Also working for you: CPT & RUC
The CPT Editorial Panel is the body responsible for maintaining the CPT code set as well as revising, deleting, and approving new codes. The panel is mainly composed of physicians nominated by national medical societies. This panel is supported by the CPT Advisory Committee, comprising specialty society representatives seated in the AMA House of Delegates. These representatives, also known as CPT advisors, review code change proposals and monitor the outcomes of the panel meetings, providing verbal comments if necessary. AAOS, along with other orthopaedic subspecialty societies, has CPT advisors devoted to this work.
The RUC is another multi-specialty committee within the AMA that provides recommendations to CMS, which are then used to create RVUs that are finalized in the Medicare Physician Fee Schedule (MPFS). RVUs are then multiplied by the annually established conversion factor to become the dollar amount physicians get paid for each service or procedure performed. Similar to CPT, AAOS and other orthopaedic subspecialty societies have advisors who participate in this process, reviewing survey data that is then presented to the RUC at in-person meetings throughout the year. Advisors will also review and address any orthopaedic procedures that have been nominated to CMS’ potentially misvalued services list.
AAOS’ participation in the RUC is crucial to ensuring the recommendations sent to CMS are based on real-world input from physicians and qualified healthcare professionals and reflect current medical practice on the services they perform in daily patient care. This input ultimately informs how physicians get paid.
The advisors dedicate numerous hours to CPT and RUC activities, including preparing for meetings and participating in conference calls and the meetings themselves. These are volunteer positions, and advisors are not reimbursed for their time away from their practices.
Resources
AAOS has several resources on coding and reimbursement for members, in large part due to the work of the CCRC. For example, the AAOS Global Service Data for Orthopaedic Surgery (GSD) is a two-volume e-book documenting more than 17,000 orthopaedic procedures, with current coding rules and bundled services guidelines. The e-book is updated annually and indicates which pre-, intra-, and postoperative services are bundled with each procedure. This product was developed by the CCRC, which helps maintain the yearly publication of this data.
The CCRC has also helped develop and maintain Code-X. Any AAOS member may pay to subscribe to Code-X, a web-based and mobile coding platform designed to simplify coding workflows and improve reimbursement outcomes. It contains ICD-10, HCPCS codes, cross references to RVUs, NCCI edits, as well as the information contained in the GSD.
Additionally, the committee will assist with reviewing and responding to coding questions that are submitted to AAOS. Responses are vetted by experts who are directly involved in CPT and RUC activities, providing accurate coding advice. Webinars on coding-related topics are also held throughout the year and presented by members of the committee.
Stay up to date with CCRC
These are only a fraction of the activities in which the CCRC is involved. The committee meets three times per year to review and address other payer policy issues, educational content, and issues related to the Medicare Physician Fee Schedule (MPFS), Outpatient Prospective Payment System, and ICD-10. CCRC members spend many hours throughout their careers working within the proper channels to ensure correct coding and obtain proper reimbursement on behalf of the membership. The work of the committee directly impacts the ability of orthopaedic surgeons to provide the highest-quality patient care.
Interested in CCRC? Check the CAP website for open CCRC positions or BOC positions. (The BOC has two rotating seats appointed to the committee.)
Joanne Willer is the director of coding and reimbursement resources within the Office of Government Relations, staffing the CCRC and serving as the liaison for the AAOS CPT & RUC advisors.
New webinar: Coding ICD-10 PCS
On Aug. 26, the AAOS Coding Coverage and Reimbursement Committee (CCRC) will provide an in-depth discussion of ICD-10-PCS (Procedure Coding System), the coding system used exclusively for reporting inpatient hospital procedures. The presenters, Brian Cunningham, MD, FAAOS, CCRC liaison to the AHA Editorial Advisory Board, and Christine Banks, KZA consultant, will offer practical guidance on the structure and application of ICD-10-PCS codes, clarify key distinctions between ICD-10-PCS and CPT coding, and help attendees navigate common areas of confusion when selecting the appropriate code set. Accurate procedure coding is essential for compliant reporting, reimbursement, and healthcare data integrity. Whether you are a coding professional, physician, or healthcare administrator, you’ll gain valuable insights to support accurate inpatient procedure reporting.
The event will take place Aug. 26 from 7:15 to 8:15 p.m. CT. Register to strengthen your understanding of inpatient procedure coding and gain practical insights that support accurate, compliant reporting.
Suggestions on future coding webinar topics can be emailed to coding@aaos.org.