Gastroenterologists could see lower Medicare reimbursement across nearly every site of service in 2027 under CMS’s proposed payment rules. The AGA estimates an average 5% decline for office-based endoscopy and about 3% for endoscopy performed in ASCs and hospital outpatient departments. Facility payment cuts would be particularly pronounced for some upper-GI procedures, with ASC payments for many upper endoscopies projected to fall about 8%.
The proposed conversion factors would also fall, by 1.19% for qualifying APM participants and 1.68% for others, following expiration of the temporary 2.5% increase enacted for 2026.
Another significant change would replace G2211 with a percentage-based modifier, while a new policy could reduce payment for additional same-day E/M services to 50%. For EGD with biopsy and colonoscopy with snare polypectomy, AGA estimates potential combined RVU reductions of up to 25% and 21%, respectively, when qualifying E/M services are billed on the same day.