ACS Strongly Opposes Medicare Payment Cuts that Threaten Surgical Care

On November 4, the Centers for Medicare & Medicaid Services (CMS) released its 2027 Medicare Physician Fee Schedule (MPFS) final rule, which contains harmful payment policies that threaten surgical practices and patients’ timely access to care. The ACS is aggressively opposing these policies and pressing for changes to protect surgeons and patients, as it has since its extensive comments that were submitted in September.

Effective January 1, Medicare’s conversion factors will decline 2.31% for clinicians who do not qualify for an advanced alternative payment model and 1.83% for those who do. Much of the decline reflects expiration of Congress’s temporary 2026 payment increase. Individual service payments will vary.

CMS also finalized a reduction when a separately identifiable office or outpatient visit accompanies a procedure with a zero-day global period. When furnished by the same physician or another physician of the same specialty in the same group, the highest-valued service will receive full payment; each additional affected service will receive 80%.

CMS narrowed its proposed 50% reduction and excluded procedures with 10- and 90-day global periods. The ACS continues to oppose any discount for these distinct services.

Several decisions were favorable: CMS paused postoperative visit reporting using code 99024 and accepted RUC-recommended values for five surgical code families. For major joint replacements, CMS adopted RUC-recommended physician-work values instead of deeper proposed cuts, although these values remain approximately 10%–13% below 2026 levels.

Significant concerns remain, including the existing 2.5% physician-work efficiency adjustment and practice expense changes that the ACS has challenged and continues to advocate against. With practice costs rising, repeated reductions threaten access, particularly in communities with limited surgical options.

The fight for sustainable Medicare payments that recognize surgeons’ work and protect patients’ access to surgery continues, and the ACS will press Congress to address the conversion-factor decline and reverse the efficiency adjustment while challenging policies that undervalue surgical care. 

Watch for additional ACS updates and calls to action.