On Jan. 22, HCFA released four possible options for calculating the resource-based practice expense which represents 45 percent of a physician's payment. If any of the four options are implemented, orthopaedic surgeons can expect an overall reduction in their Medicare reimbursement of between 9 and 16 percent for all orthopaedic services, with the greatest cuts in the surgical codes. Other specialties could experience even more drastic cuts. Payment for cardiac surgery could be decreased by up to 44 percent; thoracic surgery, 40 percent; and neurosurgery, up to 30 percent. Chiropractors could receive an increase of as much as 54 percent; podiatrists, 41 percent; and optometrists, 40 percent. Family practice could receive an increase of as much as 19 percent and internal medicine, 4 percent.