CY 2027 Physician Fee Schedule Final Rule
Conversion Factor, G2211 Retirement and Same-Day E/M Payment
Summary of the Rule or Edit Change
CMS published the CY 2027 Medicare Physician Fee Schedule final rule on November 4, 2026, and the cut landed deeper than the July proposal. The conversion factor for qualifying APM participants is $32.95, down $0.62 (-1.83%) from $33.57. For everyone else it's $32.63, down $0.77 (-2.31%) from $33.40. CMS blames most of the drop on math, not policy: the one-year +2.50% bump Congress gave CY 2026 under Public Law 119-21 simply expires, so a chunk of this "cut" is really just last year's temporary raise falling off a cliff. Statutory updates were small (+0.75%/+0.25%), offset by a -0.12% work RVU adjustment.
Two provisions changed meaningfully between proposed and final. First, CMS backed off its harshest same-day E/M proposal: when a physician bills a separately identifiable office/outpatient E/M visit alongside a 0-day global procedure on the same date, the highest-paid service still gets 100%, but the other service now pays 80%, not the 50% CMS floated in July. CMS also dropped the proposal to extend this cut to 10- and 90-day global procedures, so it's limited to 0-day globals only. Second, G2211 doesn't survive as a standalone add-on code. It's retired and rebuilt as modifier B1, which adds 16% to the associated E/M payment at every level. A new modifier B2 covers practitioners in a Shared Savings Program ACO or LEAD Model Participant Provider, adding 32%; B2 is voluntary and those claims count toward the ACO's beneficiary assignment and expenditure benchmarks, so it's a decision that touches more than the billing office.
On remote monitoring, CMS finalized most of what it proposed but delayed the hardest part: RTM is limited to established patients and a separately reportable initiating visit is required, but the requirement that RPM/RTM work be done only by practice-employed clinical staff (not contractors) doesn't kick in until January 1, 2029.
Action Required for Billing Teams
- Re-run your 2027 budget at $32.63 (or $32.95 for APM-qualifying clinicians). Show the dollar gap against 2026 collections by specialty and payer mix.
- Pull your G2211 claim volume now. Build the EHR/charge-capture change to replace the G2211 line item with modifier B1 (or B2 for ACO-participating providers) before January 1.
- Re-price same-day E/M-plus-global-procedure claims at 100%/80%, not the 50% you may have modeled off the proposed rule.
- Flag any RPM/RTM program using contracted (non-employee) clinical staff. You have until January 1, 2029 on staffing, but confirm your established-patient and initiating-visit documentation is already clean for 2027.
For the full specialty-by-specialty breakdown of this rule, read our CY 2027 Medicare Physician Fee Schedule RCM guide. For the G2211-to-modifier transition specifically, see our G2211 retirement and modifier B1/B2 billing guide.
Verifiable References
- CMS. Calendar Year (CY) 2027 Medicare Physician Fee Schedule Final Rule (fact sheet). cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-final-rule
- American Hospital Association. CMS Issues CY 2027 Physician Fee Schedule Final Rule. aha.org/news/headline/2026-11-04-cms-issues-cy-2027-physician-fee-schedule-final-rule
- American College of Cardiology. CMS Releases Final 2027 Medicare Physician Fee Schedule and Hospital OPPS Rules. acc.org/Latest-in-Cardiology/Articles/2026/11/05
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