Medicare 2027 Final Fee Schedule: 2.31% Conversion Factor Cut and 20% Same-Day Visit Reduction
Medicare will pay most physicians 2.31% less per relative value unit in 2027 under the final physician fee schedule CMS released Nov. 4, 2026. The conversion factor for non-APM physicians falls from $33.40 to $32.63; for qualifying APM participants it falls 1.83%, from $33.57 to $32.95. The July proposal had projected cuts of 1.68% and 1.19%. Most of the decline reflects expiration of the one-year 2.5% increase Congress gave for 2026. CMS cut its same-day payment reduction (modifier -25 E/M with a 0-day-global procedure) to 20% from a proposed 50% and narrowed its scope. The rule drew 44,287 comments and takes effect Jan. 1, 2027.
A deeper-than-proposed conversion factor cut lands on every Medicare-exposed practice on Jan. 1, 2027, while the softened same-day policy changes which visit and procedure combinations are at risk. Finance and revenue-cycle leads can now replace proposal-based assumptions with final numbers.
Use it for: re-forecasting 2027 Medicare revenue for procedural and mixed E/M-plus-procedure practices, and for replacing July proposal assumptions in budgets and PE or lender models with the final figures.
Watch out for: the article reports program-wide conversion factors, not practice-level impact; specialty mix, locality and APM status drive actual change. Payer contracts tied to Medicare rates may also reprice, so the cut can ripple beyond Medicare volume.
Try this: pull 2026 Medicare claims, count same-day modifier -25 E/M visits billed with 0-day-global procedures, and apply the 20% reduction to the lower-paid service. Then compare against the conversion factor framework to size the full 2027 gap.
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