CY2027 physician fees, proposed: a 1.68% lower conversion factor and a same-day visit cut

Modifier 25 is how a significant, separately identifiable visit gets past the bundling edit on a procedure day. The proposed 2027 physician fee schedule would change what that visit pays once it is through.

The proposed same-day rule

When an E/M visit billed with modifier 25 is on the same date as a procedure with a 0-, 10- or 90-day global period, the highest-valued service would pay 100% and the others 50%. The cut does not stack on a procedure already reduced by the multiple-procedure rule.

From the edits side, that splits one question into two. Today, clearing the edit with modifier 25 is what gets the visit paid. Under the proposal, a correctly cleared visit next to a global-period procedure would still be paid at a reduced rate.

What it does to a real claim

99214-25 with 20610-RT, priced live on October 23, 2026, in two places (ZIP of the place of service):

Open this comparison already priced and change the codes or ZIPs to your own.

The conversion factor falls too

Why it falls: the one-year 2.5% increase Congress provided for 2026 only expires. The small statutory updates for 2027 (+0.25% for most physicians, +0.75% for qualifying APM participants) and a budget-neutrality adjustment don't make up for it.

What to do now

• Model your top procedure-plus-visit pairs by locality.
• Don't load proposed rates. They are not final.
• Check payer contracts that pay "percent of Medicare" for which year's schedule they reference.