--- title: 'Morning Brief — Thursday, November 5, 2026' type: 'episode' url: 'https://doc.social/episodes/morning-brief-2026-11-05' show: 'doc social Morning Brief' show_url: 'https://doc.social/podcasts/morning-brief' published: '2026-11-05' audio: 'https://media.doc.social/podcasts/morning-brief/2026-11-05.mp3' --- # Morning Brief — Thursday, November 5, 2026 CMS CY 2027 physician fee schedule final rule (CMS-1848-F, on public inspection Nov 4, publishes Nov 9): nonqualifying APM CF $32.6286 (-2.31% from $33.4009; proposed was -1.68%), qualifying APM CF $32.9548 (-1.83%); anesthesia nonqualifying CF $20.1056 (from $20.4976); no new efficiency adjustment until CY 2029 rulemaking; CMS declines to remove orthopaedic surgery and neurosurgery from the… ## Summary 5 stories this morning, for surgeons and the people who support them. - **CMS CY 2027 physician fee schedule final rule (CMS-1848-F, on public inspection Nov 4, publishes Nov 9): nonqualifying APM CF $32.6286 (-2.31% from $33.4009; proposed was -1.68%), qualifying APM CF $32.9548 (-1.83%); anesthesia nonqualifying CF $20.1056 (from $20.4976); no new efficiency adjustment until CY 2029 rulemaking; CMS declines to remove orthopaedic surgery and neurosurgery from the mandatory ASM low back pain cohort (performance years begin Jan 1, 2027)** — Final rule filed for public inspection at 5 p.m. ET Nov 4 (FR doc 2026-22743, 2,468 pages). CF math (Tables D-B1 to D-B4): 2026 CF without the one-year 2.5% statutory increase, x 0.25%/0.75% update, x -0.12% budget neutrality. Efficiency adjustment (2.5%, finalized CY 2026) applies every 3 years. ASM specialty comments called out of scope. Proposed-rule percentages per AHA, July 14, 2026: https://www.aha.org/news/headline/2026-07-14-cms-issues-cy-2027-physician-fee-schedule-proposed-rule [Source](https://public-inspection.federalregister.gov/2026-22743.pdf) - **CMS CY 2027 OPPS/ASC final rule (on public inspection Nov 4, publishes Nov 6): 2.3% OPD/ASC update (3.2% market basket less 0.9 pt productivity; proposed 2.4%); ASC weight scaler 0.872 to 0.814; CMS estimates ASC musculoskeletal payments +6%, nervous system +6%, eye -1%, GI -1%; TKA +4%, THA +5%, total shoulder +7%, rotator cuff repair (29827) +35%, percutaneous SI fusion +7%, facet/epidural injections and lumbar facet RFA -3%; 618 codes added to ASC CPL; 637 services removed from IPO list (phase two, non-MSK families; phase three CY 2028)** — Final rule with comment period, FR doc 2026-22739 (1,270 pages). Tables 113-114 give CMS's ASC impact estimates; CMS attributes MSK/nervous/cardiovascular gains to their higher share of device-intensive procedures, since device portions are held constant between OPPS and ASC while the scaler falls. CY 2026 IPO removals were mostly musculoskeletal. [Source](https://public-inspection.federalregister.gov/2026-22739.pdf) - **Zimmer Biomet Q3 2026: net sales $2.063B (+3.1% reported, +3.7% cc); knees $767.5M (-2.6% cc; US -2.0%, international -3.4% cc); hips $536.5M (+7.0% cc; US +5.8%); S.E.T. $578.3M (+7.1% cc); Technology & Data, Bone Cement and Surgical $180.6M (+13.0% cc); FY26 organic cc growth guidance raised to 3.0-3.5% (from 2.25-3.25%), adjusted EPS $8.50-8.60 (from $8.47-8.59)** — Earnings release dated Nov 4, 2026 (8-K Ex. 99.1). Comparison to Stryker's Q3 (knees +1.2% cc, hips -0.7% cc) from Stryker's Oct 29 release, covered in the 2026-10-30 episode, which said Zimmer's knee number would test whether Stryker's soft knee quarter was company-specific. [Source](https://www.sec.gov/Archives/edgar/data/1136869/000119312526446145/zbh-ex99_1.htm) - **Globus Medical announces it has acquired Synaptive Medical, a cranial surgical visualization, navigation, planning and MRI company, through a court-appointed receivership; closed Aug 4, 2026; price undisclosed** — Globus release dated Nov 3, 2026 (GlobeNewswire, Audubon PA): priority is continuity, service and support for the installed base; long-term commercial strategy still being finalized. Receiver Richter's Second Report (June 30, 2026) to the Ontario Superior Court names Globus Medical Inc. as purchaser under a subscription agreement after a 22-round auction on June 15 among selected bidders (three strategic bids); receivership ordered April 28, 2026 on application of Export Development Canada; purchase price in a confidential appendix: https://cdn.richter.ca/wp-content/uploads/2025/03/12-second-report-of-the-receiver-dated-june-30-2026-.pdf ; approval and reverse vesting order July 10, 2026. [Source](https://orthospinenews.com/2026/11/04/globus-medical-acquires-synaptive-medical-strengthening-its-position-in-cranial-neurosurgery/) - **Neurosurgery, CSM-S trial economic evaluation: in 144 US patients with one-year cost data, mean total societal costs were $62,383 after posterior cervical decompression and fusion, $53,074 after ACDF and $47,426 after laminoplasty; laminoplasty had the highest QALY gain (0.792 vs 0.732 ACDF, P=.08; vs 0.698 PCDF, P=.01); 96% and 99.7% probability of being cost-effective vs ACDF and PCDF at $150,000/QALY** — Whitmore, Ghogawala et al., Neurosurgery, online Nov 3, 2026 (doi 10.1227/neu.0000000000004268). Randomized 2:3 anterior vs posterior (laminoplasty or PCDF at surgeon discretion); as-treated, one-year horizon, societal perspective; laminoplasty n=28. [Source](https://pubmed.ncbi.nlm.nih.gov/42975416/) ### Contribute to the Brief Faculty can send the show a note — a reaction to a paper, a correction, a read on a rule change — either written, which we shape for broadcast and read in the show's voice, or as a voice note under three minutes, which airs in your own voice. Send one from [Studio](https://next.doc.social/studio). Not on doc social yet? [Contribute a lecture or join the network](https://next.doc.social/contribute) — doc social is a clinical education platform for clinicians, and this show is one part of it. _Narration is synthesized. Reporting and editorial judgement are ours, and every story above links to its source._