Acuña AJ, et al. - Given the influence of a perceived decrease in the total surgical time required to perform total knee arthroplasty (TKA) operations on changes in reimbursement in TKA by CMS, researchers sought to assess changes in operative time over time and the factors associated with variations in operative time via querying NSQIP database. A total of 140,890 TKAs conducted between January 1, 2008, and December 31, 2017, were included in the final analysis (61.9% female, mean age (±SD): 49.83 ± 9.52 years). Across the study period, the mean operative time recorded was 92.60 minutes. As per the multivariable analysis, significant influencers of operative time are age, gender, functional status, anesthesia type, body mass index, operative year, transfusion requirements, and preoperative laboratory findings. As per univariable analyses, resident involvement and type of procedure are significant. They observed a decrease in the percentage of emergent procedures, shorter lengths of stay, and decreased probabilities of superficial wound infection, deep wound infection, pulmonary embolism, DVT, sepsis, and readmission during this period. They recommend considering this information in regard to physician reimbursement as providers are maintaining operative times and work effort while decreasing factors that affect outcomes in the peri-operative period.