Annual update hub

2027 Physician Fee Schedule: What Is Proposed to Change

The proposed rule was released July 14, 2026. The final rule is expected in November for January 1, 2027. This page tracks every proposal that touches the guides and tools, and states what is proposed versus final.

By Michael MacKechnie, MD, CM, FRCSC, FABOS, FAAOS, orthopaedic surgeon. Reviewed September 2026; reflects the CY 2027 proposed rule. Nothing on this page is final until the final rule publishes.
Status: proposed, not final
Everything below is a proposal. The 2026 rules remain in force on every page of this site until January 1, 2027. When the final rule publishes, each item here will be marked finalized, withdrawn, or changed, and the affected chapters, the engine, and the calculator will be updated together.

1. Conversion factor

Proposed: $32.84 for clinicians outside advanced APMs (2026: $33.40) and $33.17 for qualifying APM participants (2026: $33.57), because the one year 2.5 percent increase expires. Affects every dollar figure on the site that starts from the Medicare rate; the wRVU values themselves are separate.

2. G2211 becomes a modifier

Proposed: delete G2211 as a code and replace it with a modifier appended to the office visit, increasing that visit's payment by 16 percent rather than paying a flat amount. The underlying rule, longitudinal responsibility for the patient, is unchanged; the arithmetic changes with the visit level. Affected: the G2211 chapter, the G2211 question page, the E/M Assistant engine, and every example that uses 0.33 wRVU.

3. Same day E/M plus procedure

Proposed: when a visit and a procedure are billed the same day, the highest valued service pays in full and additional same day services pay at 50 percent. This lands on modifier 25 and modifier 57 claims for Medicare and reshapes the injection plus evaluation day. Affected: the modifier 25 chapter, the joint injection question page, the modifier 57 question page, and the orthopaedic and sports medicine chapters.

4. Telehealth

Proposed: Medicare continues to decline the 98000 to 98015 family and continues to accept office codes with place of service 10 or 02 and modifier 95 or 93, paying 98016 alone. Flexibilities currently run through December 31, 2027. Affected: the telehealth question page.

What to do now

Nothing changes in your documentation until January. Comments on the proposed rule were due September 14, 2026. This page and the changelog will carry the final rule the week it publishes.

Back toAll guides