The 56 Cents Coming Out of Every RVU
CMS proposes a $32.84 conversion factor for CY2027, down 1.68%. We price the cut by practice shape, read the specialty impact tables, and set the September 14 comment clock.
The proposed Medicare conversion factor for 2027 is $32.8409.
That's the number CMS put in the CY2027 Physician Fee Schedule proposed rule on July 14, and it applies to every clinician who isn't a qualifying APM participant. This year's factor is $33.4009, so the proposal takes 56 cents out of every RVU you bill.
QPs get their own factor: $33.1693, down 40 cents. Anesthesia drops to $20.4165 on the QP side.
For context, the factor peaked at $36.09 in 2020. The 2027 proposal lands $3.25 below that peak, a 9% nominal decline over seven years, before you count a single point of inflation (chart below).
Why it drops
The rule's own arithmetic is almost sympathetic. Non-QPs get a +0.25% statutory update (QPs get +0.75%), and everyone gets an estimated +0.53% budget-neutrality bump from proposed work-RVU changes.
Then the one-year 2.5% increase Congress passed in H.R. 1 expires on December 31, and the two raises drown (chart below).
Congress has played this exact game before: the 2023 CAA claw-back, the March 2024 mid-year fix that split that year into two factors. A year-end patch is possible again, and a revenue plan that assumes one is a plan to be surprised.
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