Non-Opioid Pain Management After Surgery — and Why Policy Is Catching Up

Non-opioid pain management uses a mix of tools — regional anesthesia, non-opioid medications, and cold with compression — to control pain after surgery while relying less on narcotics. It works, patients often prefer it, and Medicare policy has finally started paying for it: the NOPAIN Act now reimburses hospitals and surgery centers separately for qualifying non-opioid options used during outpatient surgery.

For years the clinical case for going lighter on opioids ran ahead of the payment system. That gap is closing. Here’s the state of it.

The problem the surgery starts

Surgery is a common first exposure to opioids, and the prescriptions routinely outrun the need. A widely cited review found opioids are frequently left over and unused after surgery — leftovers that become their own risk in the home.^[1] Controlling pain with fewer narcotics isn’t only about comfort in the first week; it’s about what doesn’t end up in the medicine cabinet after.

What “non-opioid pain management” actually includes

There’s no single product that replaces an opioid. The approach is layered — several tools, each doing part of the job:

Approach	What it does
Regional anesthesia and nerve blocks	Targeted numbing that reduces the pain signal at the source.
Non-opioid medications	Acetaminophen, anti-inflammatories, and others, often scheduled rather than as-needed.
Cold and compression	A mechanical, drug-free way to manage the swelling and pain that drive so much of the early discomfort.

Used together, these can carry a meaningful share of post-op pain, which is what lets patients reach for the pill less often.

Where cold and compression fits

Cold and compression is the non-drug piece most patients can keep using at home. It pairs continuous cold with active pneumatic compression — the cold slows the pain signaling and inflammation, the compression pumps fluid away from the surgical site instead of letting it pool.^[2] That’s more than ice can do, and it targets the exact swelling-and-pain cycle that makes the first two weeks hard.

The link to lower opioid use is where it earns its place in a non-opioid plan:

• In a randomized trial after total knee replacement, patients using computer-assisted cryotherapy used significantly fewer opioid tablets in the early days than those without it.^[3]
• A 2025 study of arthroscopic rotator cuff repair found patients may experience a reduction in pain and narcotic use with a postoperative cold therapy regimen.^[4]
• In a survey of 2,060 WRS Group patients, 70% reported using fewer opioids during recovery and 75% reported effective post-op pain relief. Those patients were surveyed about their experience, not remotely tracked.^[5]

We go deeper on the drug-free side of this in our guide to managing post-op pain without over-relying on opioids →.

Why policy is catching up

The clinical logic was never really in dispute; the payment design was the holdout. When a non-opioid option was bundled into the procedure payment, the facility ate its cost — so the system nudged toward the opioid.

The NOPAIN Act was written to remove that nudge. It gives hospitals and ambulatory surgery centers a separate Medicare payment for qualifying non-opioid pain management used during outpatient surgery, without cutting the procedure payment — in effect from 2025 through 2027.^[6] As of January 1, 2026, that qualifying list includes the Game Ready GRPro 2.1 cold and compression system.^[7] For the policy detail, see What Is the NOPAIN Act? →.

The takeaway for a practice: the reimbursement finally lines up with the recovery plan a lot of surgeons already wanted to run.

Where WRS Group fits

WRS Group provides Game Ready cold and compression to surgical practices and their patients, with 60,000 patients treated. If you want help building a non-opioid recovery option into your practice or your own recovery, reach out to WRS Group directly.

---

Frequently asked questions

Can you manage surgery pain without opioids?
Often you can manage most of it with a layered non-opioid approach — regional anesthesia, non-opioid medications, and cold with compression — and use far fewer narcotics. Your surgeon’s plan comes first.

Does cold and compression reduce opioid use?
Studies link it to lower opioid use after surgery, and in a survey of 2,060 WRS Group patients, 70% reported using fewer opioids during recovery.^[3-1][5-1]

What’s the difference between cold and compression and just ice?
Ice gets cold and warms quickly and does nothing for fluid buildup. A cold-and-compression system holds the cold steady and actively pumps swelling away from the site.^[2-1]

Does insurance pay for non-opioid options?
For outpatient surgery in a hospital or ASC, the NOPAIN Act now provides separate Medicare payment for qualifying non-opioid products through 2027. Home and other settings follow different rules.^[6-1]

Is this only for certain surgeries?
No. There’s no approved-procedure list under the NOPAIN Act; qualifying non-opioid products can be used across covered outpatient procedures where appropriate.^[6-2]

---

References

---

1. Bicket MC, Long JJ, Pronovost PJ, Alexander GC, Wu CL. Prescription opioid analgesics commonly unused after surgery: a systematic review. JAMA Surgery. 2017;152(11):1066–1071.↩︎
2. Block JE. Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: a narrative review. Open Access Journal of Sports Medicine. 2010;1:105–113. PMID: 24198548.↩︎↩︎
3. Thijs E, Schotanus MGM, Bemelmans YFL, Kort NP. Reduced opiate use after total knee arthroplasty using computer-assisted cryotherapy. Knee Surgery, Sports Traumatology, Arthroscopy. 2019;27(4):1204–1212. PMID: 29725749.↩︎↩︎
4. Xiao AX, et al. [Postoperative cold therapy and pain/narcotic use after arthroscopic rotator cuff repair.] Journal of Shoulder and Elbow Surgery. 2025. (Verify full citation + finding wording against the primary article before publish.)↩︎
5. WRS Cold Compression Scores — patient-reported outcomes survey, n = 2,060 (WRS Group internal data, 2026).↩︎↩︎
6. Centers for Medicare & Medicaid Services. CY 2025 / CY 2026 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule. https://www.cms.gov/newsroom/fact-sheets/cy-2025-medicare-hospital-outpatient-prospective-payment-system-ambulatory-surgical-center-payment↩︎↩︎↩︎
7. Avanos Medical. NOPAIN Act & Avanos. https://avanos.com/resources/nopain-act-and-avanos/↩︎