A radiologist wraps up a morning read. The report is clean, the workflow hummed.
The bill that just became law will pay less for that same work starting January 1.
CMS finalized the CY2027 Medicare Physician Fee Schedule on November 4. The numbers landed harder than the July proposal. Radiology groups need a clear reference before the year turns. Here it is.
THE 2027 MPFS RADIOLOGY FRAMEWORK
🔹 THE CONVERSION FACTOR DROP
The new conversion factor is $32.63. That is a -2.31% reduction, or -$0.77, versus the current 2026 figure for non-APM participants. Providers in qualifying Advanced Alternative Payment Models face a -1.83% cut, down $0.62. According to PBS Radiology Business Solutions, CMS had originally proposed -1.68% for non-APM and -1.19% for APM physicians in July. Both final numbers are steeper.
🔹 WHY THE CUT GOT BIGGER
The Working Families Tax Cut Act included a one-time 2.5% physician pay bump. That provision expired. Its exit pulled the floor out from under the final conversion factor calculation. No new offset replaced it.
🔹 SPECIALTY-BY-SPECIALTY IMPACT
CMS published its own estimates of net payment change when all rule adjustments are factored in together.
Diagnostic radiology: +1%
Interventional radiology: +3%
Nuclear medicine: +1%
Radiation oncology: +2%
ACR flagged the critical caveat: actual impacts may be less because the conversion factor decrease runs against those specialty-level gains.
🔹 THE MODIFIER 25 CHANGE
This is the one that hits interventional rads directly. CMS is cutting reimbursement when an office visit and a procedure are billed on the same day using modifier 25. The original July proposal set that reduction at 50%. The final rule brings it down to 20%.
One more boundary that matters: the policy applies only to 0-day global procedures. The 10-day and 90-day global periods are excluded, which is a meaningful protection for surgeons and proceduralists with longer post-op obligations.
What this means in practice: when an interventional radiologist evaluates a patient for treatment appropriateness and then performs a same-day image-guided procedure, the second service takes a 20% hit.
The Medical Group Management Association, which represents over 15,000 medical practices, called it a direct interference with same-day care delivery. That concern is not abstract for high-volume IR centers.
THE SAVE-THIS CHECKLIST
Before December 31, your billing team should confirm:
1. Which IR codes fall into 0-day global periods
2. Which E/M services are routinely paired with same-day procedures using modifier 25
3. Where APM participation status stands for each provider in your group
4. Whether your RVU projections for 2027 budgeting reflect the $32.63 floor
If you are building your 2027 pro forma, bookmark this. The gap between the proposed rule and the final rule is real, and groups that modeled July numbers will be starting the year short.
Radiology has absorbed conversion factor cuts in multiple consecutive years. The specialty-level offsets from RVU changes soften the blow on paper. The practical question is whether your group’s specific payer and volume mix actually captures those gains, or whether the $0.77 drop is what you feel most.
👉 Follow Jonathan Govette, CEO of Oatmeal Health, for daily healthcare insights on LinkedIn. Deeper dives in The Oatmeal Bite on LinkedIn: https://www.linkedin.com/newsletters/the-oatmeal-bite-7368331304385314817/
Author:
CEO/Co-Founder @ Oatmeal Health | AI Lung Cancer Screening | Almost Became a Doctor | Engineer | Follow to Share What I’ve Learned Along the Way
