2027 Medicare Physician Fee Schedule: Conversion Factor and What Changes

The Short Answer

• 2027 conversion factor: $32.6286 for most clinicians, down from $33.4009 in 2026, a cut of about 2.3%.
• Qualifying APM Participants: $32.95, down from $33.57 (about 1.8%).
• Anesthesia: $20.1056 per unit, down from $20.4975. See our anesthesia calculator with 2027 rates.
• Start date: January 1, 2027. CMS released the final rule (CMS-1848-F) on November 4, 2026.
• Biggest hidden cuts: G2211 is replaced by a smaller modifier, the work GPCI floor ends in 49 areas, and hip and knee replacement drop about 18%.

Look Up Any Code: 2026 vs 2027

Type a CPT or HCPCS code to see what Medicare pays nationally in 2026 and in 2027 under the final rule. Rates come straight from the CMS relative value files.

Need the rate for your city or state? Our Medicare fee lookup now has 2027 rates for every Medicare locality, built from the final rule's 2027 relative values and local cost indexes.

What Common Codes Will Pay in 2027

This is CMS's own comparison from the final rule, at national rates for clinicians who are not Qualifying APM Participants:

Office visits drop about 3% to 5%, a little more than the conversion factor cut. Hospital visits drop 3% to 4%.

Why Medicare Pays Less in 2027

For 2026, Congress added a one-year 2.5% increase to physician pay. It ends on December 31, 2026. CMS's fact sheet says this means "current law requires -2.50% reduction in Medicare payment under the PFS compared to CY 2026."

• The small yearly updates in current law are +0.25% for most clinicians and +0.75% for Qualifying APM Participants.
• Changes to work RVUs reduce the conversion factor by another estimated 0.12% to keep the fee schedule budget neutral.
• Put together, the conversion factor falls about 2.3% for most clinicians and about 1.8% for Qualifying APM Participants.

Congress has stepped in late in past years to soften cuts. Until it does, plan on the final rule numbers.

G2211 Is Replaced by Modifiers B1 and B2

In 2026, G2211 was a separate add-on code worth $17.37 nationally, the same amount at every visit level. For 2027, CMS dropped G2211 and made it a modifier instead:

• Modifier B1 goes on the office or home visit code and raises that visit's work RVUs by 16%.
• Modifier B2 raises work RVUs by 32%. Only clinicians in a Shared Savings Program ACO or the LEAD Model can use it. It is voluntary and can be billed for all of their Medicare patients, not just assigned ones.

CMS describes B1 as a 16% increase, but it applies to the work RVUs only, not the whole payment. That makes B1 worth less than G2211 for most visits. Here is the office visit plus the add-on, nationally:

A practice that billed G2211 with most 99213 visits loses about 12% on those visits, not 3%. Update your billing system before January 1 so G2211 stops going out and B1 or B2 goes on the visit line instead.

A New Cut for Same-Day Minor Procedures

When a separate office visit happens on the same day as a procedure with a 0-day global period, Medicare will pay the more expensive service in full and the other at 80%. CMS had proposed 50% and had wanted to include 10 and 90-day procedures too, but dropped both ideas.

Example: a 99214 visit ($131.17 in 2027) and a large joint injection, 20610 ($64.93), on the same day. The visit is paid in full and the injection at 80%, so the pair pays $183.11 instead of $196.10, which is $12.99 less. You still need modifier 25 on the visit.

The Work GPCI Floor Ends

Medicare adjusts every payment for local costs. For years, the law kept the work part of that adjustment (the work GPCI) from going below 1.0. That floor is not in the 2027 files: CMS's 2027 GPCI table is labeled "without 1.0 floor."

As a result, 49 of 109 Medicare localities have a work GPCI below 1.0 in 2027. The lowest are Arkansas and Mississippi at 0.948. For a 99213 visit, that takes about $2.21 more off the payment in those states, on top of the national cut. Rural practices feel this most.

Hip and Knee Replacement Drop About 18%

CMS cut the work RVUs for total hip replacement (27130) and total knee replacement (27447) from 19.11 to 16.70, after the AMA's RUC flagged them as site-of-service anomalies. With the lower conversion factor, CMS's own table shows total knee replacement falling from $1,159.35 to $953.08. Because the fee schedule is budget neutral, the money removed is spread across all other services.

Other Changes Worth Knowing

• Advance care planning: new codes G0572 and G0573 cover planning done by clinical staff under direct supervision. 99497 and 99498 now count only the billing practitioner's own time.
• Remote monitoring: remote therapeutic monitoring is limited to established patients and needs a separately billed initiating visit. The rule that only practice-employed staff can do the work is delayed to 2029.
• Behavioral health: shared medical appointments get their own codes, and collaborative care (CoCM) work RVUs go up.
• Lab fee schedule: cuts based on private payer data are capped at 15% a year through 2029.
• Rural health clinics and FQHCs: can keep billing non-behavioral health visits by telecommunication through December 31, 2027.

What to Do Before January 1

• Update your Medicare fee schedule and charge master to the 2027 rates.
• Remove G2211 from your billing rules for 2027 dates of service and set up modifier B1 (or B2 if you are in an ACO).
• Check your locality's 2027 work GPCI, especially in rural areas.
• Review visits billed with minor procedures, since the same-day 80% rule applies to them.
• Rerun your 2027 revenue forecast. A 3% to 12% drop on Medicare visits adds up fast.

Related: RVU values for common CPT codes, 99213 vs 99214 and E/M code level calculator.

Sources: CMS fact sheet, Calendar Year (CY) 2027 Medicare Physician Fee Schedule Final Rule (November 4, 2026); CMS-1848-F final rule files: Addendum B (relative value units, updated November 5, 2026), Addendum E (GPCIs), Impact on Payment for Selected Procedures and Modifier B1/B2 adjusted RVUs; CMS 2027 anesthesia conversion factors (October 28, 2026); CMS 2026 RVU26D. CPT is a registered trademark of the American Medical Association.

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