CMS has proposed cutting the Medicare conversion factor again for 2027, once the temporary 2.5 percent bump from 2026 legislation expires. Non qualifying physicians would see 32.84 dollars per relievable unit, a 1.68 percent cut from 2026’s 33.40 dollars. Qualifying APM participants would see 33.17 dollars, down 1.19 percent from 33.57 dollars. On top of that, CMS wants to cut same day evaluation and management payment to 50 percent whenever it is billed alongside a global surgery procedure, and to fold the G2211 complexity add on into a modifier worth 16 percent more. The comment period closes September 14, 2026. Nothing is final yet, but for a 3 to 5 provider practice, the arithmetic is worth running now, not in January.
Every fee schedule cycle brings a headline percentage that sounds small until it is applied to an actual year of claims. A 1.68 percent conversion factor cut reads like a rounding error. It is not one. It compounds against every code a practice bills under the physician fee schedule, on top of a same day E/M change that could cut a specific, common claim type in half, on top of a G2211 change that shifts how a complexity payment gets billed at all. None of these three moves alone would justify a headline. Together, for a practice that runs on thin staffing and a Medicare heavy patient mix, they are worth a real conversation before January 1, 2027.
This is not a call to panic before a proposed rule finalizes. It is a call to know your own number. What follows is sourced to CMS’s own fact sheet and the American Medical Association’s practice management summary, with a worked example a 3 to 5 provider practice can run against its own claims.
What CMS actually proposed for 2027
The Calendar Year 2027 Medicare Physician Fee Schedule proposed rule, released July 14, 2026, sets two separate conversion factors depending on whether a practice qualifies as an Advanced Alternative Payment Model participant. Both fall from 2026, because the temporary 2.5 percent update Congress added for 2026 expires on schedule and is not being renewed in this proposal.
| Participant type | 2026 conversion factor | 2027 proposed conversion factor | Change |
|---|---|---|---|
| Non qualifying physicians | 33.40 dollars | 32.84 dollars | Down 1.68 percent |
| Qualifying APM participants | 33.57 dollars | 33.17 dollars | Down 1.19 percent |
CMS attributes the reduction to three moving parts: the expiring 2.5 percent temporary update, a 0.53 percent budget neutrality adjustment required whenever CMS changes how it values other codes, and small statutory base updates under MACRA, a quarter of one percentage point for most physicians and three quarters of a percentage point for APM participants. The net result lands as a cut either way, and most independent practices are non qualifying physicians for this purpose, so the deeper cut applies to most of the specialties WeBill Health works with.
The same day evaluation and management change
Separately from the conversion factor, CMS proposes reducing payment for an office or outpatient evaluation and management service billed on the same day as a global surgery procedure. Under the proposal, the higher valued service, usually the procedure, gets paid in full. The lower valued service, usually the E/M visit, gets paid at 50 percent. The American Medical Association has called this “not a small adjustment,” and has warned it could push some practices toward providing care for less than it costs to deliver it.
This is a distinct proposal from the Modifier 25 cut already covered in our family medicine specific breakdown of that documentation standard, though both share the same underlying logic: CMS believes E/M work and same day procedure work overlap enough to justify a reduction, and organized medicine disagrees on how that overlap is being measured. A practice billing any same day E/M alongside a procedure, minor or major, should read both pieces, because the financial exposure and the documentation standard are two different problems that happen to share one proposed rule.
What happens to G2211
The complexity add on code G2211, used to reflect the added resource cost of ongoing, longitudinal primary care and specialty relationships, is proposed to shift from a standalone code to a modifier, valued 16 percent higher than the current add on payment. For a practice already billing G2211 regularly, the mechanics of submission change even though the underlying clinical rationale does not. Practices that are not currently billing G2211 where it applies are leaving that 16 percent increase on the table before the rule even takes effect, on top of whatever they are already missing under the current code.
What this actually costs a 3 to 5 provider practice
Get your Revenue Defense Score before running the math below by hand. Six questions, sixty seconds, and a benchmarked view of how exposed your current billing setup already is, before a single 2027 rate change is applied on top of it.
Every code paid under the physician fee schedule is priced off the conversion factor, so the cut applies across the entire claim volume a practice bills to Medicare, not just to one code family. A 3 to 5 provider practice billing 500,000 dollars a year in Medicare allowed charges as a non qualifying physician group loses roughly 8,400 dollars a year from the conversion factor cut alone, before a single same day E/M claim or G2211 submission is touched.
| Annual Medicare allowed charges | Loss from 1.68 percent conversion factor cut |
|---|---|
| 250,000 dollars | 4,200 dollars |
| 500,000 dollars | 8,400 dollars |
| 1,000,000 dollars | 16,800 dollars |
Add the same day E/M change on top, and the number stops being a flat percentage and starts depending on how often a practice’s specialty mixes office visits with same day procedures. A practice that rarely bills both on the same day barely notices it. A practice built around same day procedural care, injections, minor surgical work, in office diagnostics paired with a visit, could see a much larger share of its claim volume paid at the reduced rate. That is the piece a spreadsheet cannot answer without your actual claim mix, and it is the piece a Revenue Health Audit is built to answer with your real numbers instead of an industry average.
What to do before January 1, 2027
The comment period closes September 14, 2026. CMS typically issues a final rule around November 1, with adopted changes effective January 1, 2027. Between now and then, three things are worth doing regardless of how the final rule lands. Pull a full year of Medicare allowed charges and run the conversion factor math above against your own number, not the illustrative figures here. Audit how often your practice actually bills a same day E/M with a global surgery procedure, because that percentage of your claim volume, not the headline cut, is what determines your real exposure. And confirm your practice is capturing G2211 everywhere it applies today, so the 16 percent increase lands on a code you are already billing correctly rather than one you are still missing.
WeBill Health maintains internal payer rule libraries organized by specialty and by carrier, spanning more than 500 payer rulesets, built and updated by people who work claims in your specialty every day. Every claim receives human pre submission review against those libraries before it goes out. There is no black box and no algorithm we ask you to take on faith. When a payer changes a policy, a person updates the library and a person applies it to your claims, including a policy change as large as a full fee schedule cycle.
See exactly what the 2027 fee schedule means for your practice
A Revenue Defense Audit is a forensic review of your existing accounts receivable and your actual Medicare claim mix. We show you your real same day E/M exposure, your real G2211 capture rate, and the actual dollar impact of the 2027 conversion factor cut on your specific claim volume, not an industry average. Root cause denial work, not resubmission on repeat, is what Denial Defense 2.0 is built for, whichever way the final rule lands.
Frequently asked questions
What is the 2027 Medicare conversion factor?
The proposed rate is 32.84 dollars for non qualifying physicians, down 1.68 percent from 2026’s 33.40 dollars, and 33.17 dollars for qualifying APM participants, down 1.19 percent from 33.57 dollars. Both figures are proposed, not final, as of this writing.
Why is the conversion factor dropping if Congress raised it for 2026?
The 2.5 percent update Congress added for 2026 was temporary and expires on schedule. The 2027 proposal does not renew it, and combines that expiration with a required budget neutrality adjustment and small statutory base updates, producing a net cut either way.
What is the same day E/M with global surgery cut?
Under the proposal, CMS pays the lower valued of two same day services, usually the evaluation and management visit, at 50 percent when it is billed alongside a global surgery procedure, while the higher valued service is paid in full. This is a separate proposal from the Modifier 25 minor procedure cut.
How does the G2211 change affect billing?
G2211 is proposed to move from a standalone add on code to a modifier, valued 16 percent higher than the current payment. Practices already billing it correctly gain from the increase. Practices not yet capturing it are missing that value under the current code as well.
When does the CY2027 fee schedule take effect?
CMS typically finalizes a rule like this around November 1, with adopted changes effective January 1, 2027. Comments on the current proposal are due September 14, 2026.
How much will the 2027 cut actually cost my practice?
Apply the 1.68 percent non qualifying rate, or 1.19 percent for APM participants, to your trailing 12 months of Medicare allowed charges for the conversion factor portion. Then add your practice’s actual rate of billing same day E/M with global surgery procedures, since that determines your exposure to the second proposed cut.
Get a specific number for your practice
The figures above are illustrative. Your actual exposure depends on your actual Medicare claim mix.
Request your Revenue Health Audit. We review your existing accounts receivable and Medicare claim mix and show you exactly where 2027 exposure sits before we ever quote a number.
Prefer to talk it through? Book a 30 minute call with a US based billing manager who works your specialty.
