American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Key Congressional Champions Send Letter to CMS Opposing Cuts to Global Surgery Payments

Longstanding physician champions Reps. Ami Bera, MD (D-CA), and Larry Bucshon, MD, FACS (R-IN), led a congressional sign-on letter to the Centers for Medicare & Medicaid Services (CMS) urging the agency to adjust the evaluation and management (E/M) component of all 10-day, 90-day, and maternity global codes to include any updated office/outpatient E/M code values. The CMS calendar year (CY) 2020 Medicare Physician Fee Schedule proposed rule would increase payment values for standalone office visit E/M codes; however, the agency is proposing not to apply the payment adjustment to the E/M portion of global surgical codes. The letter, which 25 members of Congress signed, opposes this provision of the proposed rule. Arbitrarily adjusting some E/M codes but not others conflicts with current law. Changing the values for some E/M services disrupts the relativity in the fee schedule mandated by Congress as part of the Omnibus Budget Reconciliation Act  of 1989 (P.L. 101-239). Furthermore, the Medicare statute specifically prohibits CMS from paying physicians differently for the same work. Failing to adjust the E/M component of the global codes is equivalent to paying some physicians less for the same services.

For more information on the congressional sign-on letter, contact Carrie Zlatos, American College of Surgeons Senior Congressional Lobbyist, at For more information on the CMS proposed rule, contact

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