CMS 2027 Fee Schedule Cuts Threaten Providers

The 2026 one-time pay boost is expiring, and without congressional action, another real-terms cut will land hardest on the clinics and imaging centers already running on empty.

The ritual happens every year. CMS publishes its proposed Medicare Physician Fee Schedule for the coming year. Medical associations sound the alarm. Congress sometimes acts, sometimes doesn't. And providers absorb another year of payments that don't keep pace with what it actually costs to run a clinic.

This year's proposed rule for CY 2027 follows the same script. CMS has proposed a conversion factor that, without the expiring one-time 2.5% boost from the One Big Beautiful Bill Act, represents another effective pay cut in real terms for most physicians. Primary care. Radiology. Community health clinics. Independent imaging centers. All of them are looking at 2027 and running the same math: revenue flat or down, costs up 4-6%, margins shrinking.

This is not a new story. But the cumulative weight of it is. Since 2001, Medicare physician payments have fallen approximately 29% in inflation-adjusted terms. Practice costs per FTE physician rose more than 63% from 2013 to 2022. The conversion…